Submitted by (edna.saturno@ufrpe.br) on 2016-10-20T14:21:22Z No. of bitstreams: 1 Moacir Bezerra de Andrade.pdf: 486371 bytes, checksum: 997bf7f6be2c645f0415215a82b09935 (MD5) / Made available in DSpace on 2016-10-20T14:21:22Z (GMT). No. of bitstreams: 1 Moacir Bezerra de Andrade.pdf: 486371 bytes, checksum: 997bf7f6be2c645f0415215a82b09935 (MD5) Previous issue date: 2008-02-28 / Considering that the consciousness level corresponds to the degree of behavioral alert shown by individuals and that the later is subject to strong variation among neurological patients, the relevance of its evaluation and measurement becomes clear. In that account, several scales were developed and proposed to human medicine, all of them based on the analysis of the patients and consequent scoring regarding their global consciousness level every other moment. The technological development and improved research of the nervous system enhanced the neurological knowledge regarding veterinary medicine. Advances in both scientific production and medical clinic were achieved, as in the philosophical debate about animal well-being and consciousness. Yet, additional research is required in order to develop safer and more accurate clinical instruments and proceedings. The objective of the present work is to modify the Pediatric Glasgow’s Scale of Coma focusing on its application in veterinarian clinical neurology, in order to evaluate and measure the consciousness levels ofcanine patients. Another objective is to test the applicability of the Glasgow’s Scale for Dogs. This study was conducted on 30 adult canine patients, disregarding the gender, race, and weight, which presented pathological processes causing them neurological changes suitable for consciousness level evaluation. Animals were provided by the Department of Clinic Neurology and Psychobiology of the Medical Clinic for Small Animals in the Veterinary Hospital of the Department of Veterinary Medicine (DMV) of the University Federal Rural of Pernambuco (UFRPE). The Glasgow’s Scale of Coma Modified for Dogs was applied in three distinct moments (m0, m1 e m2) with an interval of 48 hours between them, leading to 90 recorded events. Data were submitted to factorial analysis, and results suggested that the Glasgow’s Scale of Coma Modified for Dogs is valid for the evaluation of the consciousness levels of adult dogs in the ambulatory routine. / Considerando-se o conceito de que o nível de consciência é o grau de alerta comportamental que o indivíduo apresenta e também, as possibilidades de variação desse parâmetro em pacientes neurológicos, observa-se a relevância de sua avaliação e mensuração. Neste sentido, várias escalas foram desenvolvidas e propostas à medicina humana e todas elas baseadas na análise do paciente e na atribuição de um escore de pontuação que propicie uma idéia global da condição do nível de consciência, momento a momento. Na medicina veterinária, devido ao desenvolvimento tecnológico e aos estudos mais acurados do sistema nervoso, houve grandes avanços na área neurológica, tanto na produção científica quanto na clínica médica e no debate filosófico sobre o bem-estar animal e a consciência. Contudo, apesar dos incrementos, deve-se ressaltar a necessidade de realização de diversas pesquisas no campo da neurologia clínica veterinária que venham viabilizar o surgimento de instrumentos e procedimentos clínicos mais seguros e eficazes. O presente trabalho teve como objetivo modificar a Escala de Coma de Glasgow Pediátrica visando sua utilização na neurologiaclínica veterinária, a fim de avaliar e mensurar os níveis de consciência de pacientes da espécie canina. Uma outra finalidade do trabalho foi a aplicabilidade da Escala de Glasgow para Cães. No desenvolvimento deste estudo foram utilizados 30 pacientes da espécie canina, adultos, sem distinção de sexo, raça, peso, portadores de processos patológicos que causem alterações neurológicas, passíveis de avaliação do nível de consciência. Os animais foram provenientes do Serviço de Neurologia Clínica e Psicobiologia da Clínica Médica de Pequenos Animais do Hospital Veterinário do Departamento de Medicina Veterinária (DMV) da Universidade Federal Rural de Pernambuco (UFRPE). A Escala de Coma de Glasgow Modificada para Cães foi aplicada nos cães em três momentos distintos (m0, m1 e m2), sendo respeitado um intervalo de 48 horas entre as análises, ocasionando 90 eventos diversos. Os dados obtidos foram tratados estatisticamente através da Análise Fatorial, que permitiu concluir que a Escala de Coma de Gvalidade construída, possuindo a capacidade de avaliar, na rotina ambulatorial, o nível de consciência em cães adultos.

Memoria (licenciado en ciencias jurídicas y sociales) / No autorizada por el autor para ser publicada a texto completo / Hay diferentes problemas que plantea el avance tecnológico en los últimos años, siendo especialmente atrayente la controversia suscitada a raíz del progresivo cambio de mentalidad desde la “santidad” de la vida humana hacia la “calidad” de la vida humana, que trajo el reclamo al “derecho de una muerte digna” y las voces favorables a la aplicación de la eutanasia. Dentro de este contexto es de extraordinario interés la problemática jurídica, médica y ética del llamado estado vegetativo permanente, que recientemente adquirió relevancia mundial con el caso de Terri Schiavo

The ESA Rosetta spacecraft investigated comet 67P/Churyumov-Gerasimenko duringtwo years from August 2014 to the end of September 2016. The dual Langmuir probewas used to measure plasma parameters including the thermal energy of theelectrons. The observed thermal energy (or temperature) of the electrons was ratherhigh, in the range 5-10 eV almost throughout the mission. However, near perihelionthe Langmuir probe measurements indicated the prevalence of two electronpopulations with distinct temperatures, one hot (5-10 eV) and one cold (less than 1eV). It has been hypothesized that the electrons of the colder population wereformed relatively close to the nucleus and that they subsequently cooled by inelasticcollisions with the neutral gas. In this project work we develop a model for studyingelectron cooling in a cometary coma. The model takes into account collisions withwater molecules as well as the influence of a radial ambipolar electric field. / Rymdsonden Rosetta från ESA undersökte kometen 67P/Churyumov Gerasimenkounder mer än två år, från augusti 2014 till slutet av september 2016.En Langumirprob användes för att undersökta plasmamiljön runt kometen, tillexempel elektronernas termiska energi. Den observerade termiska energin förelektronerna (eller elektrontemperaturen) var ganska hög, ca 5-10 eV undernästan hela uppdraget, men när kometen var nära perihelium detekterade instrumentenäven kalla elektroner, med en energi under 1 eV, distinkta från devarma. En hypotes är att dessa kalla elektroner bildas nära kärnan av att varmaelektroner genomgår inelastiska kollisioner med den neutrala gasen och tapparsin energi. I detta projekt utvecklar vi en modell för att studera elektronernasbeteende i koman. Modellen tar hänsyn till kollisioner med neutrala vattenmolekylersåväl som påverkan av ett radiellt ambipolärt elektriskt fält.

Objectives: Intracranial subdural empyema (ICSDE) can be a devastating condition, with a sequelae ranging from epilepsy, focal deficits to death. Factors affecting the outcome in subdural empyema range from level of consciousness, the extend of subdural pus at the time of diagnosis and the type of surgical procedure performed. Previous studies have conflicting results of unfavourable prognostic factors associated with ICSDE. The outcome of this condition at Steve Biko Academic Hospital (SBAH) is reported, as well as factors influencing the outcome. Methods: A retrospective analysis of all the patients admitted at neurosurgery unit of SBAH during 2006 – 2010 period with confirmed subdural empyema on brain CT scan and at surgery. Data sheet was used to collect all clinical information from patients’ records. Glasgow Outcome Scale and Henk W. Mauser grading were used to report on the outcome. Results: A total of 34 patients (20 males and 14 females) with mean age of 16.1 years were admitted with a diagnosis of ICSDE. The common presenting features were headache (58.8%), fever and seizures (47.0% each). Over 61% of patients had hemiplegia at presentation. CT scan confirmed subdural collections with 70.6% over the convexity, 23.5% at the convexity and parafalx and only 5.9% had bilateral collections. Complicated paranasal sinusitis was the origin of infection in 82.3%, followed by meningitis with 8.8%. Burr hole washout was done in 52.9% of patients, while 38.2% had burr holes with drains in situ and 8.8% had craniotomy to evacuate the subdural pus. All the patients were given empiric triple antibiotic therapy. Streptococci species were the most cultured organisms in the 19 (56.0%) patients who had positive cultures, however 15 (44.0%) patients had negative cultures. Resistance to penicillin was noted in 5.0% of cases only. Sixty-five percent of patients had good outcome with no seizures nor neurological deficits. The overall mortality was 15.0% in this study, with none from patients who had craniotomy. Conclusion: Clinical presenting features and organisms cultured seems to be the same internationally, particularly those due to complicated sinusitis. Empiric triple antibiotic therapy of 3rd generation cephalosporin plus vancomycin plus metronidazole is still relevant at SBAH. Factors associated with favourable outcome were ages between 11 and 20 years, and craniotomy as the surgical procedure of choice. / Dissertation (MMEd)--University of Pretoria, 2013. / Neurology / Unrestricted

Nurses, especially those who care for the critically ill, are required to perform high-level intensive clinical care. It is common for complicated procedures such as therapeutic hypothermia (TH) to be done infrequently at small community hospitals. According to the 2020 recommendations by the American Heart Association (AHA), “prompt initiation of targeted temperature management (formally known as TH) is necessary for all patients who do not follow commands after return of spontaneous circulation to ensure optimal functional and neurological outcome” (Panchal et al., 2020, p.S366). These high-risk, low-frequency protocols typically require nurses to be able to perform these procedures in a time-sensitive manner. If the procedures are not done correctly, they can have negative patient outcomes. Patients are put into medically induced comas, maintained on ventilators, cooled to very low body temperatures, and often medically paralyzed to inhibit shivering. Each of these conditions has the potential for adverse outcomes and together can lead to poor neurological outcomes and even death (Kim et al., 2015). Health educators have the opportunity to provide knowledge and support to these nurses as a way to improve patient outcomes. In this study, a patient care checklist and an online self-learning module were developed for nurses to learn how to perform this high-risk procedure quickly and effectively. A focus group was then conducted with a group of nurses to gain feedback on the checklist and module, and these data informed specific changes to these materials. Then, drawing on a sample of 60 nurses and using a post-study design, data were collected to determine the effectiveness of the checklist and online module as compared to a control group of nurses who read a scholarly article on the same subject. Data were collected at two time points for both the experimental and control groups. The results indicated that nurses who used the online learning tool scored higher in the post-assessment than those in the control group (t = 6.092, p < .001, BCondition = 3.865), with a remarkably high effect size, r2 = 0.379. Moreover, 77% of the nurses agreed that protocols and checklists helped nurses minimize disparities in patient health outcomes. Additionally, 95% of the nurses agreed that patient care checklists helped them care for patients when delivering high-risk, low-volume protocols such as TH. This study demonstrated that online learning tools provide an effective way to educate nurses, and checklists and protocols support the implementation of high-risk, low-volume procedures such as TH.

Datenbanken finden in mehr und mehr Bereichen einen Einsatz. Angestrebter Datenaustausch zur Vernetzung von Informationen und Gewinnung zusätzlicher Kenntnisse ist wegen der Heterogenität von den Datenbanken problembehaftet. Schema- Matching beinhaltet durch das Erzeugen von Korrespondenzen zwischen Schemata eine Lösungsmöglichkeit für zumindestens einen Teil dieser Probleme. Viele Ansätze wurden schon für das Schema-Matching entwickelt und werden in dieser Arbeit dargestellt. Es werden Strategien zur Wiederverwendung näher erläutert und Erweiterungen für die Mapping-Wiederverwendung vorgestellt. Die neuen Strategien, die in dieser Diplomarbeit entstehen, wurden in dem Schema-Matching-Prototyp COMA++ integriert und zusammen mit anderen Strategien evaluiert.

In der vorliegenden Masterarbeit wird erläutert, wie ein klassischer Schema Matcher erweitert wird, um Komplexe Korrespondenzen (many-to-many-Korrespondenzen) und allgemeine Funktionen zwischen zwei Schemata auszudrücken, sowie deren automatische Entdeckung als Erweiterung der herkömmlichen Entdeckung von (1:1)-Korrespondenzen. Der letzte Punkt widmet sich dabei einem Gebiet der Datenintegration, das bisher kaum untersucht wurde, und es werden Ansätze vorgestellt, die für viele Schema Matcher eine Bereicherung darstellen können. Zu diesem Zweckwerden im ersten Teil der Arbeit Komplexe Korrespondenzen und Funktionen im Bereich des Schema Mappings ausführlich vorgestellt.

Despite the consensus that glutamatergic and GABAergic imbalance is likely to be involved in anesthesia or coma, there is little known about molecular mechanisms of action of gaseous anesthetics. The target article by Smythies (1999) is engagingly analytical and insightful, proposing novel and testable hypotheses for the molecular mechanisms of action of anesthetics as well as for processes that may be involved in coma. The most creative and convincing of his hypotheses concerns the crucial role of iron in maintaining neural respiration and energy production as well as its involvement in synaptic plasticity. Smythies' paper is certain to stimulate new ideas and experiments on the molecular mechanisms of anesthesia and coma.

Myxedema coma and pituitary apoplexy are well-known life-threatening endocrine emergencies. The coincidence of these entities is exceedingly rare. Myxedema coma occurring as a result of pituitary lesion is a much less seen entity. A high index of suspicion is often required for early diagnosis as it is of particular importance in improving survival outcomes. We present a rare case of a patient with myxedema coma presenting as bradycardia and hypotension secondary to pituitary apoplexy, which was confirmed on magnetic resonance imaging (MRI). The patient was managed conservatively with levothyroxine and stress doses of steroid, with the resolution of hemodynamic changes and a decrease in the size of the suprasellar mass.

La aritmética en coma fija tiene la propiedad de realizar operaciones con números decimales con un coste computacional entero. A pesar de no estar soportada de forma nativa por los lenguajes de programación y por las CPUs generalistas, es la aritmética ideal para aplicaciones de control industrial, simulación, informática gráfica, multimedia y señal digital, etc. Su falta de normalización y soporte impide su uso extendido en muchos campos de la informática. Esta tesis justifica la utilización de esta aritmética en el campo de los gráficos por computador. A partir de un estudio de implementación y normalización de la aritmética, se estudian incrementos de potencia relativos y precisiones obtenidas y su aplicación a la simulación discreta y de vuelo. Se analizan los algoritmos de dibujo de primitivas básicas como las líneas, con y sin aliasing, su recortado y el dibujo de circunferencias y elipses. Se presentan algunas implementaciones de algoritmos basados en la coma fija y se analiza la mejora del coste computacional y de la precisión obtenida respecto de los algoritmos de fuerza bruta y de los tradicionales. Mientras los algoritmos tradicionales suelen entregar un error comprendido entre los 0.32 y 0.45 píxeles, dependiendo de la primitiva analizada, los algoritmos basados en la coma fija no superan los 0.25 de media, igualando el error teórico generado por los algoritmos de fuerza bruta. Por otro lado, los algoritmos basados en la aritmética en coma fija suelen mejorar la velocidad media de los algoritmos tradicionales, pudiéndose a veces conseguir aceleraciones elevadas si se utilizan técnicas de paralelización. Éste sería el caso de la versión paralela del algoritmo DDA con y sin antialiasing que podría dibujar una recta con coste temporal logarítmico respecto de su longitud en píxeles. Los algoritmos obtenidos son tan sencillos que pueden ser implementados algunos de ellos en hardware dentro de un procesador gráfico de forma muy eficiente. / Mollá Vayá, RP. (2001). Aplicaciones de la aritmética en coma fija a la representación de primitivas gráficas de bajo nivel [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/15406