In-hospital complications in trauma patients are frequent and associated with increased morbidity and mortality. The aim of this study was to analyze the association between posttraumatic complications and the injured body region, injury and trauma severity, length of stay, and mortality in hospitalized trauma patients. This observational and retrospective study included 147 trauma patients with posttraumatic complications hospitalized in a university hospital located in São Paulo, Brazil. The injury and trauma severity was measured using the Abbreviated Injury Scale (AIS) and the Injury Severity Score (ISS), respectively. The association between variables was verified applying χ2 test, Fisher exact text, likelihood ratio, and Mann-Whitney U test, considering significance level of 5%. The most frequent in-hospital complications were infectious, cardiovascular, metabolic, and renal. Patients with head injury AIS score of 3 or more had higher percentage of neurological complications and those with lower extremity injury AIS score of less than 3 had higher percentage of metabolic and renal complications. There was no association between thoracic injury and cardiovascular complications, nor between types of complications and trauma severity (ISS). Patients without cardiovascular complication and those with infections had longer hospital length of stay, and mortality was higher in those with cardiovascular complications. Complication's studies in trauma patients may contribute to identify events related with poor outcome and to implement specific measures for improving quality of trauma care and patient security.
Objective To investigate the adequacy of the neuropsychological test battery proposed by the International Study of Postoperative Cognitive Dysfunction to evaluate this disorder in Brazilian elderly patients undergoing surgery under general anesthesia.Methods A neuropsychological assessment was made in patients undergoing non-cardiac surgery under general anesthesia, aged over 65 years, literate, with no history of psychiatric or neurological problems and score on the Mini Mental State Examination at or above the cutoff point for the Brazilian population (>18 or >23) according to the schooling level of the subject. Eighty patients were evaluated by a trained team of neuropsychologists up to 24 hours before elective surgery.Results Among the patients evaluated, one was excluded due to score below the cutoff point in the Mini Mental State Examination and two did not complete the test battery, thus remaining 77 patients in the study. The mean age was 69±7.5 years, and 62.34% of the subjects had ±4 years of study. The subjects had significantly lower averages than expected (p<0.001) for normative tables on neuropsychological tests.Conclusion The study demonstrated the applicability of the instruments in the Brazilian elderly and low schooling level population, but suggested the need to determine cutoff points appropriate for these individuals, ensuring the correct interpretation of results. This battery is relevant to postoperative follow-up evaluations, favoring the diagnosis of postoperative cognitive dysfunction in patients undergoing different types of surgery and anesthetic techniques.
Seasonal changes in agricultural soil use due to agroclimatic conditions affect the water cycle in watersheds. This study aimed to understand the temporal variation of runoff inherent to the seasonal occupation dynamics of the agricultural soil in the basin that drains the upper valley of the Marrecas River, upstream of the urban perimeter of Francisco Beltrão, PR. The effects of runoff were verified through flow peaks simulated by the HEC-HMS model in twelve monthly soil use scenarios, under seven precipitation return periods. The results indicated a strong relationship between bare soil and flow peaks, temporally delimiting April and March as the largest runoff generators and January and August as the smallest ones. The ratio quantified by rates of increase in flow peaks ranging from 0.78 to 1.64 m 3 s −1 per km 2 of bare soil. In addition, the survey of historical precipitation data also warns of the generation of large runoff volumes in October. Therefore, the strong correlation between the increase in flow peaks and occupation by bare soil can be quantified with good precision, but it is also necessary to consider historical precipitation records to understand the temporal distribution of runoff and flood risks.
Changes in the Brazilian Forest Code (BFC) have soften the criteria for recovery and conservation of permanent preservation areas (PPAs), enhancing processes related to surface runoff. The aim of this study is to understand the effects of changes in PPA classification criteria established by BFC of 2012 to the detriment of BFC from 1965 considering the surface runoff response in the basin draining the upper Marrecas River valley in the flow peaks. The HEC-HMS model was used to simulate flow peaks considering three land-use scenarios, representative of the current use, adapting it to PPAs fitted to the BFC of 1965 and 2012 and seven precipitation return periods. In the proposed scenarios, the use of BFC of 2012, to the detriment of that from 1965, would imply a PPA reduction from 44.5% to 13.7%, resulting in a 22.1% increase in the average flow peaks, not representing, however, a significant reduction in the flow peaks when compared to the scenario representing the current land use. Therefore, when compared to BFC of 1965, in the Brazilian new Forest Code PPAs were reduced by 69.2%, increasing peak flows by up to 30.7%, thus minimizing the legal possibilities of flood mitigation to the urban perimeter of Francisco Beltrão, Paraná State, Brazil.
Os óleos lubrificantes usados ou contaminados (OLUC) são os principais resíduos gerados no setor de reparação automotiva, considerado perigoso por causar danos ao meio ambiente e à saúde pública. Esta pesquisa avaliou o sistema de gestão dos OLUC, a eficiência do sistema de tratamento de efluente, bem como a toxicidade do efluente tratado das empresas de reparação automotiva do município de Francisco Beltrão-PR. O estudo foi desenvolvido por meio de visitas in loco, nas quais foram avaliadas as metodologias de gestão dos OLUC e o sistema de tratamento dos efluentes, em relação às normas NBR’s 9800/1987, 12235/1992 e CONAMA 357/2005 e 430/2011. A determinação da eficiência do separador de água e óleo ocorreu por meio de análises físico-químicas do efluente tratado, como a temperatura, pH, sólidos sedimentáveis, sólidos totais e óleos e graxas. As temperaturas variaram entre 26,5 º C e 29,7 º C. O pH variou entre 3,14 e 7,49. Sólidos totais variaram entre 330 mg.L-1 e 3.306 mg.L-1. Sólidos sedimentáveis apresentaram valores inferiores a 0,5 mL.L-1 até 30 mL.L-1. Óleos e graxas, valores entre 22,0 mg.L-1 e superiores a 500.000 mg.L-1. O teste de toxicidade foi realizado utilizando bioindicador Artemia salina, o resultado indicou que o efluente é tóxico em 90% dos casos.
As embalagens Tetra Brik Aseptic® (TBA), principal produto da Tetra Pak®, é um dos resíduos mais comuns nos centros de reciclagem e aterros. Composta por celulose, polietileno e alumínio, dificultando a reciclagem. Em muitos países falta infraestrutura na gestão destes resíduos, além disso, o alto custo e consumo de energia na reciclagem a torna inviável em muitas situações. Outra alternativa é a reutilização das embalagens TBA como subcoberturas em telhados, atuando como isolante térmico. Neste contexto, o objetivo desta pesquisa foi avaliar a eficiência das embalagens TBA como isolante térmico, na cobertura de edificações. A avaliação ocorreu utilizando um protótipo de madeira com forro de PVC e cobertura de telha de fibrocimento, simulando edificação residencial. O protótipo foi dividido em três compartimentos, objetivando avaliar as variações da temperatura nos compartimentos. Foram aplicados três tratamentos: no primeiro utilizou-se isolante térmico confeccionado a partir de embalagens TBA sobre o forro; no segundo, foi utilizado isolante térmico comercial sobre o forro; no terceiro, não foi utilizado isolamento térmico. As variações da temperatura foram monitoradas por sensores de temperatura, em cinco repetições. As aferições da temperatura ocorreram a cada cinco minutos no período de 60 minutos, totalizando 13 medições por compartimento. Os dados foram submetidos à análise estatística, Análise de Variância e Teste Tukey. As análises demonstraram que o isolante térmico, desenvolvido com embalagens Tetra Pak®,possui, estatisticamente, a mesma condição de isolamento térmico que o isolante comercial.
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