INTRODUÇÃO: A propriedade de induzir angiogênese torna o omento um promissor pedículo para pré-fabricar retalhos. OBJETIVO: Estabelecer a área abdominal a ser pré-fabricada por um pedículo omental e analisar o potencial de pré-fabricação (PPF) conforme o tempo de espera entre a introdução do pedículo e a elevação do retalho. MÉTODOS: Foram utilizados 44 coelhos divididos em quatro grupos (A, B, C e D). No grupo A, um fragmento de pele, tecido subcutâneo e músculo cutâneo abdominal foi totalmente separado e ressuturado. Nos demais grupos, um pedículo omental, contendo os vasos gastromentais ligados distalmente, com área equivalente a 9 cm² foi transposto e suturado ao músculo cutâneo abdominal. Um segundo procedimento de incisão e elevação de um retalho contendo pele, subcutâneo e músculo cutâneo abdominal pediculado apenas pelo omento transposto, foi realizado, variando apenas o período de espera entre os dois procedimentos de 7, 21 e 56 dias para os grupos B, C e D respectivamente. Após 15 dias do último procedimento, os retalhos foram visualizados e as áreas viáveis foram calculadas através do programa de computador Image Tool®. Cortes de áreas viáveis foram imunocoradas pelo anti-CD31 para cálculo da densidade microvascular (DMV). RESULTADOS: Os valores médio e máximo das áreas viáveis no grupo D foram respectivamente 45,29 cm² e 99,37 cm² (PPF mediano = 5,03 e PPF máximo = 11,04). Não houve diferença significativa entre as áreas viáveis do grupo D e C. As médias da DMV dos grupos B, C e D foram respectivamente 24,54 vasos/mm², 33,20 vasos/mm² e 27,03 vasos/mm² e maiores do que as médias da DMV das áreas controles de 14,63 vasos/mm², 17,33 vasos/mm² e 18,12 vasos/mm². No grupo A, houve necrose total em todos os retalhos. CONCLUSÃO: O PPF mediano do pedículo omental foi de 5,03 vezes sua área e o tempo de espera para o segundo procedimento foi de, no mínimo, 21dias / INTRODUCTION: The angiogenic induction property of the omentum makes it a promising pedicle to prefabricate flaps. OBJECTIVE: To establish the abdominal area to be prefabricated by the omental pedicle and to analyze the prefabricate potential according to the time delay between the pedicle introduction and the flap release. METHODS: 44 rabbits were divided into four groups (A, B, C and D). In group A, a piece of skin, subcutaneous tissue and abdominal cutaneous muscle has been fully released and sutured again in its place. In other groups, a 9 cm2 omental pedicle containing the gastromental vessels distally tied has been transposed and sutured to abdominal cutaneous muscle. A second procedure, an incision and release of the flap that contained skin, subcutaneous and cutaneous abdominal muscle pediculated only by the omentum, has been carried out. The only variation was the time delay between the two procedures: 7, 21and 56 days for groups B, C and D, respectively. The flaps have been inspected 15 days after the last procedure, and the viable areas have been estimated using the software Image Tool®. The pieces of viable area have been immunostained using anti-CD31 allowing the estimation of the microvascular density. RESULTS: The mean and maximum viable areas in group D were 45.29 cm2 and 99.37 cm2 respectively (average prefabricate potential = 5.03 and maximum prefabricate potential = 11.04). There was no significant difference between the viable areas in groups C and D. The mean microvascular densities of groups B, C and D were 24.54 vessels/mm2, 33.20 vessels/mm2 and 27.03 vessels/mm2 respectively. This was higher than the mean microvascular densities of the control areas, which were 14.63 vessels/mm2, 17.33 vessels/mm2 and 18.12 vessels/mm2. In group A, there were total necrosis in all flaps. CONCLUSION: The prefabricate potential of the omentum was found to be 5.03 times its area and the delay time for the second procedure was, at least, 21 days

BACKGROUND: Late identification of deteriorating children undermines timely implementation of life-saving measures to prevent cardiopulmonary arrest (CPA) or death. The Pediatric Early Warning System (PEWS) has been validated for use in pediatric acute care settings for early identification of children at increased risk of physiologic deterioration, yet there is a dearth of evidence of the use of PEWS in primary care. Implementing the PEWS in primary care could guide rural primary care practitioners to early detection and prompt management of deteriorating children. This DNP project evaluated the attitudes and perceptions of rural practitioners towards the implementation of the PEWS scoring tool. METHODS: A cross-sectional descriptive design was conducted using an anonymous online survey via an email listserv. RESULTS: Seventeen practitioners responded to the survey, but only 14 participants met criteria for inclusion – 2 males and 11 females. The sex of one participant was not reported. Participants areas of specialization include 79% specialized in family practice, 79% pediatric specialists 14% and (7%) listed as "Other." Thirty-one percent of participants reported a travel distance of over 60 miles, while 39% reported a travel distance of over 60 miles lasting over 60 minutes via ground from a place of care to a hospital that specializes in the pediatric emergency care, and pediatric care respectively. Although 92% reported they have not heard of the PEWS tool prior to this survey, 54% strongly agree that the PEWS could help prevent cardiopulmonary arrest or death. Similarly, 54% of respondents reported they strongly agree that the PEWS can help identify deteriorating children, while 39% somewhat agree. Over 62% strongly agree that implementing the PEWS is appropriate in primary care, while 31% somewhat agree. Fifty-four percent of participants strongly agree they could use the PEWS tool in their practice. DISCUSSION: Participants have a positive view of the PEWS tool and perceive implementation of the PEWS to be a vital clinical decision support tool that could lead pediatric primary care providers to early detection of deteriorating children before the occurrence of an adverse event. Further study could determine the generalizability of implementing the PEWS in primary care.

Magister Chirurgiae Dentium (MChD) / Aging is a biological process under the influence of genetic and pathological factors wh ich can be more or less advanced in different individuals with the same, chronological age. Silverman (1961) defined age as a three-dimensional phenomenon wherein there is a constant interaction between chronologie age, physiologic age and psychologic age. Vinton (1964) also points out that there are physiologic, pathologic, psychologic and sociologic changes which are unique to the latter span of life. These changes are not synonomous with illness as long as they fall within the physiologic limits of normality. If these limits are exceeded the changes are pathological in character. Age is a phase of life which brings about changed circumstances and a new pattern of life which must be adapted to and accepted. This may necessitate an invironmental change which causes a loss of friends and social standing and may bring about a feeling of insecurity in some people, suppressing the incentive to live for the future. To counter these emotions it is imper~tive to create a quality of life in which the aged can be productive within the limits of their physical abilities and which will give them the assurance that they are still needed by society. Life expectancy is determined by the circumstances under which people live. The average age of life expectancy during the Roman period and the Middle Ages was 25 to 30 years; today it is 70 years (Sharry 1974). Nature normally maintains an equilibrium between young and old so that each can provide for the other's needs. Modern science and technology however have upset that balance and brought about new developments in medicine ich have succeeded in increasin and reducin infant mortality, causing the ectancy explosion. This has brought about a situatiop where 10 million humans are born and only 3 million die every month; thus the inflow into life far exceeds the outflow and there is consequently a global increase of 80 million people per year. At this rate the world population will double itself by the end of this century (Pistorius 1978). Birth control has been encouraged as a counter measure to this and the result has been a marked drop in the birth rate, especially in the more advanced countries of the world. This changing relationship between the birth and death rates is referred to as the population-shift. In the U.S.A. 4% of the total population was over the age of 65 years at the beginning of this century. In 1975 the figure was 10% and at the present rate of population-shift will be 20% by the end of this century (Winkler 1977). In England and Wales 6% of the total population was over the age of 65 years in 1931, 10% in 1951 and 12% in 1962. In Scotland 7% was over the age of 65 years in 1931, 9% in 1951 and 10% in 1962 (Storer 1965). In Canada 4,8% of the total population was over the age of 65 years in 1921 and 7,8% in 1971. The average life expectancy was 50 years in 1900 and 70 years in 1960 (Sherman 1970). This pattern of change is also evident in the Republic of South Atrica but there is a marked variation in the different ethnic groups (White, Asian, Coloureds and Blacks) making up the South African population.

Modern intelligent monitoring systems use digital computer technology to analyze and evaluate physiological vital signs. This analytical and evaluative process is performed by algorithms developed for this purpose. The degree of 'intelligence' of the monitoring system is dependent on the 'sensitivity' and 'specificity' of these algorithms. In order to develop robust and clinically valid algorithms, a database of representative waveforms is required. The aim of this thesis was to create a neonatal vital signs database to be used for this purpose, by means of a computer-based central station. The computer was interfaced to a number of neonatal monitors (Neonatal ICU, Groote Schuur Hospital). The monitors were interrogated to obtain patient condition, ECG waveforms and respiration waveforms using the impedance technique. When possible, percentage oxygen saturation was also captured. The database contains 509 documented clinical records obtained from 35 patients and 20 records containing examples of technical alarm conditions and high frequency noise. Additional patient record data is included. Clinical events recorded include apnoea, bradycardia, periodic breathing tachycardia, tachypnoea and normal traces. These events were recorded against a variety of signal quality conditions that have been characterized in Appendix C. A prototype rate detection algorithm was checked using samples from the database.

This study examined the effects of concurrent speech and computer tasks on each other and on measures of physiologic arousal in 30 young adults. Physiologic measures included galvanic skin response, heart rate, and heart rate variability. Participants completed a speech-only task, two computer-based tasks, and combined speech and computer-based tasks. Participants spoke for 60 seconds on a procedural discourse prompt. Acoustic measures included the mean and standard deviation of intensity and fundamental frequency as indices of prosody, speaking time ratio to reflect pausing, and speech rate. The primary computer task (with two levels of difficulty) involved making formatting changes to a paragraph with a word processor. The secondary computer task involved data entry (typing items from a shopping list into categories in a spreadsheet). Errors were tallied for each computer task. Statistical analysis revealed a significant decrease in words per minute in both the data entry and the easier formatting tasks; the proportion of speaking time decreased for all three concurrent computer tasks. Performance on all computer tasks was negatively impacted by speech. There was a significant decrease in the number of words correctly sorted and the number of correct formatting changes. The physiologic changes were limited; it remains unclear whether the heart rate increases during combined computer task and speaking conditions resulted from the addition of cognitive load or the respiratory changes inherent in speaking compared to silent task performance. Findings reflect bidirectional interference between speech and computer-based tasks while multitasking. These findings can help speech-pathologists to create therapy activities that are more like what patients will be experiencing in their everyday lives, such as practicing speech during computer tasks.

Background. Diabetes requires significant disease management, patient-provider communication, and interaction between patients, family members, caregivers, and care teams. Emerging patient-facing technologies, such as cellular-enabled glucose meters, can facilitate additional care support and improve diabetes self-management. This study evaluated patient acceptability, feasibility, and efficacy of a diabetes care support program facilitated by cellular-enabled glucose meters. Methods. A two-phase study approach was taken. Get In Touch – Phase 1 (GIT-1) was a 1-month pilot involving patients with type 1 and type 2 diabetes. Get In Touch – Phase 2 (GIT-2) was a 12-month randomized controlled crossover trial involving patients with poorly-controlled type 2 diabetes. Results from GIT-1 and preliminary results from GIT-2 are presented. Results. GIT-1 participants with type 1 (n=6) and type 2 (n=10) diabetes reported the intervention and cellular-enabled glucose meter were easy to use and useful while identifying potential areas of improvement. GIT-2 participants in both the intervention (n=60) and control (n=60) groups saw significant improvements in treatment satisfaction and A1c change, with intervention participants experiencing slightly greater improvements in each after 6 months (p=0.09 and p=0.16, respectively) compared to control participants. Conclusions. Patients reported favorable acceptability of the intervention. Preliminary results from a randomized trial demonstrated potential of intervention to improve patient-reported and physiological health outcomes. Future studies should evaluate feasibility and efficacy over a longer period of time, with a greater number of participants, and targeting different populations of patients with diabetes. Provider perspectives and changes in provider behavior, clinical work flow, and caregiver burden should also be assessed.

A maioria das calcificações em tecidos moles na região de cabeça e pescoço são achados radiográficos incidentais. Com o crescente uso da Tomografia Computadorizada de Feixe Cônico na Odontologia (TCFC) há um aumento do número desses achados, visto que o exame permite a visualização das estruturas em três dimensões. Esse estudo estabeleceu uma metodologia para identificar algumas dessas calcificações. Um observador calibrado analisou 100 exames de TCFC e as respectivas panorâmicas, quanto à presença de Ossificação do Complexo Estilo-Hióideo (OCEH), tonsilólitos e ateromas. Adicionalmente os processos estilóides foram mensurados. As correlações para as radiografias panorâmicas foram estatisticamente significante entre idade e comprimento do processo estilóide. As correlações para os exames de TCFC foram estatisticamente significantes entre idade e tonsilólitos, idade e o comprimento do processo estilóide e idade e ateromas. Houve diferença estatística significante (Wilcoxon p<0,05) entre os exames de TCFC e panorâmicas quanto à presença de tonsilólitos, presença de OCEH e para as mensurações dos processos estilóides. Foi detectada maior quantidade de calcificações em tecidos moles nos exames de TCFC. A identificação das calcificações em tecidos moles é importante no diagnóstico diferencial de muitas patologias incluindo os flebólitos. Portanto o profissional deve ficar atento a correta interpretação dessas estruturas, buscando evitar erros e omissões, para que possa oferecer ao paciente opção correta de tratamento se for necessário. / The most common soft tissue calcifications in head and neck region are incidental findings in radiographic images. The use of Cone Beam Computed Tomography in Dentistry, has increased these incidental findings mainly, because CBCT allows a third dimension view. The goal of this study was to differentiate the styloid chain ossification (SHCO), tonsilloliths and calcified atheromas. Based on a specific methodology, one calibrated observer analysed 100 panoramic and CBCT exams from the same patients regarding these alterations. Afterwards, the styloid process was measured at the same exams. The correlations tests for the panoramic exams were statistically significant between age and styloid process length. The correlations tests for CBCT exams were statistically significant between age and tonsilloliths, age and styloid process length and age and calcified atheromas. There was a difference statistically significant (Wilcoxon p<0.05) between CBCT and panoramic exams regarding: presence of tonsillolith, presence of SHCO and styloid process length. It was detected more quantity of soft tissues calcifications in CBCT exams. The identification of soft tissues calcifications is important for the differential diagnoses of many pathologies including phlebolits. Therefore the professional should be able to do a correct image interpretation in some cases in order to avoid mistakes and offer the patient a treatment if is necessary.

O objetivo do presente trabalho foi o de estudar as relações entre as variações na hidratação inicial, no tamanho e na qualidade fisiológica das sementes de soja. Para tanto, 3 lotes (cultivar BRS-157), com qualidade fisiológica distinta, tiveram as sementes padronizadas por espessura (13/64 de polegada) e submetidas a embebições a 20ºC em períodos variáveis (3, 6, 9 e 12h). Após as embebições, as sementes foram reclassificadas por espessura e, posteriormente à estimativa da freqüência de indivíduos presentes em cada fração, submetidas às avaliações da qualidade fisiológica. Foi verificado que a qualidade fisiológica afeta o teor de água e a espessura alcançados pelas sementes de soja durante a embebição; assim, há a possibilidade de comparar o desempenho fisiológico relativo de lotes por intermédio dos dados de freqüência de espessura em sementes hidratadas. / The objective of the present work was to study the relationships among the variations in the initial hydration, size and on physiologic quality of soybean seeds. Three lots (cv.BRS-157) with different physiologic quality had the seeds standardized according to thickness (13/64 inches) and submitted to hydration at 20ºC in variable periods (3, 6, 9 and 12h). After the hydration, the seeds were classified according to thickness and subsequently the individuals' frequency in each fraction was estimated, submitted to evaluations of the physiologic quality. The physiologic quality was verified to affect the water content and the thickness reached by the soybean seeds during the hydration; therefore, it is possible to compare the relative physiologic quality of lots through the thickness frequency data in moisturized seeds.

Metais são largamente empregados em implantes (endopróteses), principalmente nos que tem finalidade ortopédica. O meio fisiológico representa um meio extremamente agressivo, provocando corrosão que pode resultar em sérios problemas aos pacientes que recebem os implantes. Passou-se a utilizar revestimentos sobre o metal-base de implantes para melhorar a sua resistência à corrosão. Mais recentemente, revestimentos porosos de cerâmica, que permitem ao tecido ósseo um crescimento por entre a porosidade, passaram a ser empregados, pois assim dispensam o uso de cimentos acrílicos na fixação da prótese ao osso. A hidroxiapatita (HA) é um dos revestimentos cerâmicos cuja aplicação comercial tem crescido bastante, principalmente em cirurgias de substituição total de quadril (total hip replacement). A corrosão eletroquímica em metais comumente empregados em endopróteses e que aceitam o revestimento de hidroxiapatita (aços inox F138 grau 2, 316L grau 1 e liga Co-Cr-Mo F75)foi estudada, de forma a determinar se este tipo de revestimento influi ou não na corrosão. Através de testes, e análises metalográficas e de microscopia eletrônica de varredura, foi analisada a corrosão destes materiais em dois meios fisiológicos (Soro Bovino e Soro Fisiológico), comparando-se os resultados obtidos com e sem revestimento de hidroxiapatita. / MetaIs are widely used in implants (endoprostheses), mainly in orthopedic ones. The physiologic solution is very aggressive, and promote the metal corrosion, that may drive the patient that receive the implant to serious complications. Coatings over the base metal are being applied to improve the corrosion resistance. Recently, ceramic porous-coating began to be used. This kind of coating allows the bone tissue to ingrowth into the pores of HA-coated, and so avoid the use of acrylic cements do bind the protesis to the bone. The hidroxiapatite (HA) is one of the ceramic coatings that the commercial use have been growing, mainly in total hip replacement surgeries. The Electro-Chemical corrosion in the most common metaIs used in endoprostheses, that accept the HA-coat was studied (stainless steels F138 grade 1 and 316L grade 2 and F75 Co-Cr-Mo alloy). By this way, this study aimed to tell if the HA-coat has any influence in the corrosion rate. Trough chemical-electro corrosion tests, and metallographies, and electronic microscopy, the corrosion of these metaIs was analyzed in two different physiologic solutions, confronting the results between HA-coated and non coated samples. Coated samples had, in both solutions, a lower corrosion rate. The bovine solution was more agressive between non coated samples. But fisiologic solution was more agressive with coated samples. Between coated samples, F75 alloy had the lower corrosion rate. But F138 stainless steel without coating was the less corroded.

Leong Hok Chong. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1998. / Includes bibliographical references (leaves 87-103). / Abstract also in Chinese. / Chapter 1. --- Abstract --- p.5 / Chapter 2. --- Introduction --- p.8 / Chapter 3. --- Noninvasive Methodology in Pulse Wave Assessment --- p.20 / Chapter 3.1 --- Applanation Tonometry --- p.20 / Chapter 3.2 --- The Instrument: Sphygmocardiograph --- p.20 / Chapter 3.3.0 --- Reproducibility of Sphygmocardiograph --- p.27 / Chapter 3.3.1 --- Background --- p.27 / Chapter 3.3.2 --- Study Aims --- p.28 / Chapter 3.3.3 --- Subjects and Methods --- p.28 / Chapter 3.3.4 --- Statistical Analysis --- p.29 / Chapter 3.3.5 --- Results --- p.31 / Chapter 3.3.6 --- Discussion --- p.35 / Chapter 4. --- Radial Artery-Derived Aortic Augmentation Indexin Normotensive Subjects --- p.36 / Chapter 4.1 --- Background --- p.36 / Chapter 4.2 --- Study Aims --- p.36 / Chapter 4.3 --- Subjects and Methods --- p.38 / Chapter 4.4 --- Statistical Analysis --- p.38 / Chapter 4.5 --- Results --- p.39 / Chapter 4.6 --- Discussion --- p.52 / Chapter 5. --- Changes of Arterial Pulses in Normotensive Subjects with Family History of Hypertension --- p.56 / Chapter 5.1 --- Background --- p.56 / Chapter 5.2 --- Study Aims --- p.58 / Chapter 5.3 --- Subjects and Methods --- p.58 / Chapter 5.4 --- Statistical Analysis --- p.59 / Chapter 5.5 --- Results --- p.59 / Chapter 5.6 --- Discussion --- p.65 / Chapter 6. --- Radial Artery-Derived Aortic Augmentation Indexin Hypertensive Subjects --- p.67 / Chapter 6.1 --- Background --- p.57 / Chapter 6.2 --- Study Aims --- p.68 / Chapter 6.3 --- Subjects and Methods --- p.68 / Chapter 6.4 --- Statistical Analysis --- p.69 / Chapter 6.5 --- Results --- p.69 / Chapter 6.6 --- Discussion --- p.70 / Chapter 7. --- Changes of Arterial Pulses in Antihypertensive Therapies: Comparison between Diuretic and Long-Acting Calcium Antagonist --- p.72 / Chapter 7.1 --- Background --- p.72 / Chapter 7.2 --- Study Aims --- p.73 / Chapter 7.3 --- Subjects and Methods --- p.73 / Chapter 7.4 --- Statistical Analysis --- p.74 / Chapter 7.5 --- Results --- p.74 / Chapter 7.6 --- Discussion --- p.76 / Chapter 8. --- General Remarks and Conclusion --- p.80 / Chapter 9. --- Acknowledgments --- p.86 / Chapter 10. --- References --- p.87