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Search Results: 1 - 10 of 19150 matches for " Ricardo Sukiennik "
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Perfil de pacientes com paralisia cerebral em uso de gastrostomia e efeito nos cuidadores Profile of patients with cerebral palsy using gastrostomy and effects on caregivers
Fernanda Pellin Susin,Vaneila Bortolini,Ricardo Sukiennik,Renata Mancopes
Revista CEFAC , 2012,
Abstract: OBJETIVO: caracterizar o perfil de pacientes com paralisia cerebral em uso de gastrostomia e verificar o efeito que tal procedimento ocasiona nos cuidadores. MéTODO: foi realizado estudo transversal de caráter qualitativo e quantitativo. A pesquisa foi feita com pacientes do Hospital da Crian a Santo Ant nio - Complexo Hospitalar Santa Casa que tivessem diagnóstico médico de Paralisia Cerebral (PC) em uso de gastrostomia. Foi aplicado um questionário aos cuidadores contendo quest es quantitativas, qualitativas e dados sobre a caracteriza o da amostra. RESULTADOS: houve predominancia de renda mensal de até dois salários mínimos, e uma configura o familiar caracterizada pelo pai trabalhar e a m e n o atuar no mercado de trabalho. Dentre os motivos para a indica o do procedimento, a dificuldade de degluti o esteve presente entre todos os sujeitos, seguido das pneumonias de repeti o e baixo peso. Observa-se um grande número de pacientes que fizeram uso de sonda antes da gastrostomia, com tempo de permanência acima de um mês. Destacam-se os principais benefícios observados com a coloca o da gastrostomia: ganho de peso, diminui o dos problemas respiratórios e redu o de interna es. A partir dos relatos dos cuidadores percebe-se a ocorrência de sentimentos como de medo do desconhecido, resistência e aceita o, dificuldades e benefícios. CONCLUS O: observa-se que problemas de alimenta o s o frequentemente encontrados como indica o para coloca o de gastrostomia em crian as com PC. Os cuidadores sentem medo quanto à impossibilidade de alimentar a crian a pela via oral. Porém, após a cirurgia, grande parte deles relatou benefícios, como por exemplo, ganho de peso e redu o das interna es. PURPOSE: outlining the profile of patients with cerebral paralysis using gastrotomy and investigating the effects of such procedure on caretakers. METHOD: it is a cross-sectional study with a qualitative and quantitative nature. The research was carried out with patients of Hospital da Crian a Santo Ant nio - Complexo Hospitalar Santa Casa who had medical diagnosis of Cerebral Paralysis (CP) using gastrostomy. A questionnaire was applied on the caretakers containing quantitative and qualitative questions and data regarding the sample features. RESULTS: there was predominance of monthly income of up to two minimum wages and a family configuration featuring the father as the worker and the mother with no labor activity. Among the reasons for the recommendation for such procedure, deglutition difficulty was present among all the subjects followed by repeated pneumonias a
Pratiques discursives et enjeux du pathos dans la présentation de l’Intifada al-Aqsa par la presse écrite en France Discursive Practices and the Stakes of Pathos in the Presentation of the Al-Aqsa Intifada in the French Press
Claire Sukiennik
Argumentation et Analyse du Discours , 2008,
Abstract: Mon étude porte sur les formes de mise en scène pratiquées par le discours qui construit les effets de pathos, et plus particulièrement sur la pitié et l’appel à la pitié. Mon cadre de recherche se limite à la mise en mots de l’Intifada al-Aqsa dans la presse écrite fran aise. L’Intifada a éclaté en Isra l et dans les territoires occupés en septembre 2000. Je me propose de problématiser ici la question paradoxale de la contribution au pathos de trois effets d’objectivité notoires : la citation ou le discours rapporté, les indications chiffrées et quelques effets de réel notoires, tels que les descriptions de paysages et les portraits de protagonistes palestiniens et israéliens. Il n’est pas rare en effet que les auteurs des articles de mon corpus utilisent l’instrument de la compassion en tant que procédé argumentatif alors que la déontologie de l’écriture de presse présente le devoir de neutralité rationnelle comme une obligation fondamentale. My study is based on the patterns of discourse which produce emotion and more particularly pity and the appeal to pity. My research is limited to the verbal description of Al-Aqsa Intifada in the French press, in Israel and in the “Occupied Territories” during September 2000. My purpose is to show how three effects of objectivity, namely quotation or direct speech, the appeal to numbers and some effects of reality such as the descriptions of landscapes and the portrayal of Palestinian and Israeli protagonists, actually contribute to the production of pathos. I will show that contrary to the code of ethics of the written press, which consists of presenting rational neutrality as a formal obligation of the press, compassion as an argumentative means is quite frequently used by the authors of the articles in question.
Concordancia no diagnóstico radiológico das infec??es respiratórias agudas baixas em crian?as
Sarria, Edgar;Lima, Jo?o A. B.;Fischer, Gilberto B.;Barreto, Sergio S. Menna;Fl?res, José A. M.;Sukiennik, Ricardo;
Jornal de Pediatria , 2003, DOI: 10.1590/S0021-75572003000600007
Abstract: objective: to evaluate the inter-observer agreement of radiological diagnosis of lower respiratory tract infections in children. methods: chest x-rays from 60 children younger than 5 years of age were evaluated by three physicians: a pediatric radiologist (pr), a pediatric pulmonologist (pp) and an experienced emergency pediatrician (ep). all children had sought an emergency room due to acute respiratory infections with apparent lower respiratory tract involvement. observers were blinded to the original diagnostic conclusions, but clinical and laboratory data from the initial medical evaluation were provided with each film. variables were grouped into five categories: a) film quality; b) site of abnormality; c) radiological patterns; d) other radiographic images; e) diagnosis. inter-observer agreement was assessed using kappa statistics, accepting prevalence-bias-adjusted values (pabak). results: kappa values for each of the three observer pairs (rp vs. pp, rp vs. ep, and pp vs. pe) were 0.41, 0.43, and 0.39, respectively. the overall inter-observer agreement was moderate (0.41). agreement on other variables was as follows: regular for "film quality" (0.30); moderate for "site of abnormality" (0.48); fair for "radiological patterns" (0.29); moderate for "other radiographic images" (0,43); and moderate for "diagnosis" (0.33). the overall intra-observer agreement was "moderate" (0.54), which is below the agreement values reported by other studies on chest x-ray variability. conclusions: inter-observer variability is an intrinsic characteristic of the interpretation of chest x-rays, and the diagnosis of lower respiratory tract infections in children remains a challenge. most of our results were similar to those previously reported.
Outcome after systemic thrombolysis is predicted by age and stroke severity: an open label experience with recombinant tissue plasminogen activator and tirofiban
Rudiger J. Seitz,Judith Sukiennik,Mario Siebler
Neurology International , 2012, DOI: 10.4081/ni.2012.e9
Abstract: Stroke patients can recover upon intravenous thrombolysis but remain impaired in lacking recanalization. We sought to investigate the clinical effect of systemic thrombolysis with an intravenous bolus of 20 mg recombinant tissue plasminogen activator (rtPA) and an infusion of body-weight adjusted tirofiban for 48 hours in acute stroke. This prospective, open label study, included 192 patients (68±13 years, 50% males) treated between 1 January 2005 and 31 December 2007. The neurological deficit was assessed with the National Institutes of Health stroke scale (NIHSS). Follow-up was performed using a telephone interview of modified Rankin Scale (mRS) and Barthel index. The site of cerebral artery occlusion was determined by computed tomography or magnetic resonance angiography. Data were analyzed by descriptive statistics and multiple regression analyses. Eighty-one percent of the patients had an infarct in the middle cerebral artery (MCA) territory and were severely affected with a median NIHSS of 10. During treatment on the Stroke Unit the patients improved (P<0.0001) except for patients who deceased due to malignant infarction (n=10) or cerebral haemorrhage (n=6); 18 percent deceased within 100 days which was predicted by older age (76 + 10 years, P<0.05) and more severe affection on admission (P<0.0001). Also, these patients more frequently had atrial fibrillation (P<0.03) than the surviving patients. The surviving patients had more frequently distal MCA occlusions and improved further (P<0.0001). At follow-up 48% of the patients had a mRS of 0 and 1. Similarly to intravenous thrombolysis with body-weight adjusted rtPA, poor prognosis was predicted by higher age, more severe neurological deficit at stroke admission, and a proximal MCA occlusion. Half of the surviving patients improved to no or minimal impairment.
Thermodynamic properties of the liquid Hg-Tl alloys determined from vapour pressure measurements
Gierlotka W.,Fitzner K.,Sukiennik M.
Journal of Mining and Metallurgy, Section B : Metallurgy , 2002, DOI: 10.2298/jmmb0204237g
Abstract: The partial vapour pressure of mercury over liquid Hg-Tl liquid solutions were determined in the temperature range from 450 to 700 K by direct vapour pressure measurements carried out with the quartz gauge. From the measured ln pHg vs. T relationships activities of mercury were determined. Using Redlich-Kister formulas logarithms of the activity coefficients were described with the following equations: From which all thermodynamic functions in the solutions can be derived.
Przydatno NT-proBNP w diagnostyce dysfunkcji rozkurczowej lewej komory u chorych po ostrym zawale serca leczonych pierwotn angioplastyk
Iwona ?wi?tkiewicz,Marek Koziński,Arkadiusz Grubecki,Adam Sukiennik
Polish Journal of Cardiology , 2007,
Abstract: Wprowadzenie: Dysfunkcja rozkurczowa lewej komory (leftventricle- LV) mo e wi za si z wyst powaniem remodelingu LV oraz pogorszeniem rokowania u chorych po ostrym zawale serca z uniesieniem odcinka ST (ST-elevation myocardial infarction - STEMI) z zachowan funkcj skurczow LV. Cel pracy: Ocena wyst powania dysfunkcji rozkurczowej LV przy u yciu echokardiografii doplerowskiej, jej zwi zku z remodelingiem LV oraz przydatno ci oznaczania st enia N-końcowego fragmentu mózgowego peptydu natriuretycznego w osoczu (N-terminal pro-brain natriuretic peptide - NT-proBNP) w diagnostyce dysfunkcji rozkurczowej LV u chorych po STEMI leczonych pierwotn angioplastyk wieńcow (primary percutaneo-ustransluminal coronary angioplasty -pPTCA). Materia i metodyka: Ocenie poddano 98 pacjentów (75 m czyzn, 23 kobiety). Badanie echokardiograficzne wykonywano w dniu wypisu ze szpitala (p) oraz po 6 miesi cach (k), oceniaj c wymiaryjam serca oraz parametry funkcji skurczowej (frakcja wyrzutowa - EF, ang. ejection fraction) i rozkurczowej LV (E/A-iloraz maksymalnych pr dko ci nap ywu mitralnego: wczesnego oraz w czasie skurczu przedsionka; DT - czas deceleracji wczesnego nap ywu mitralnego; IVRT - czas rozkurczu izowolumetrycznego). Dysfunkcj rozkurczow LV o profilu zaburzonej relaksacji rozpoznawano przy E/A105 ms, a o profilu restrykcyjnym przy E/A>2,0 i DT<130 ms. Remodeling LV rozpoznawano przy wzro cie wymiaru końcowo-rozkurczowego LV (LVend-diastolic diameter- LVEDd) po 6 miesi cach o >10%. NT-proBNP mierzono przed pPTCA (p) oraz po 6 miesi cach (k). Wyniki: W dniu wypisu ze szpitala stwierdzono zachowan funkcj skurczow LV w ca ej grupie chorych oraz dysfunkcj rozkurczow LV o profilu zaburzonej relaksacji w grupie chorych z NT-proBNP(p) powy ej mediany (>309,3 pg/ml). Po 6 miesi cach wykazano zachowan funkcj skurczow LV i dysfunkcj rozkurczow LV o profilu zaburzonej relaksacji w ca ej grupie chorych oraz brak remodelingu LV u 86% badanych. W grupie chorych z NT-proBNP(p) powy ej mediany stwierdzono brak poprawy funkcji skurczowej LV oraz wzrost LVEDd. Po 6 miesi cach dysfunkcja rozkurczowa LV o profilu zaburzonej relaksacji wyst powa a w ca ej grupie chorych niezale nie od NT-proBNP(k). Stwierdzono ujemne korelacje pomi dzy NT-proBNP(k) a DT(p) i NT-proBNP(k) a DT(k) (odpowiednio: Rs=-0,33, p=0,0021; Rs=-0,21, p=0,0552). W analizie wieloczynnikowej wysokie NT-proBNP(k) by o niezale nym czynnikiem predykcyjnym skrócenia DT(k) a niska EF, krótki DT przy wypisie ze szpitala oraz wysoka maksymalna aktywno kinazy fosfokreatynowej we krwi i wysokie NT-proBNP
Value of C-Reactive Protein in Predicting Left Ventricular Remodelling in Patients with a First ST-Segment Elevation Myocardial Infarction
Iwona Swiatkiewicz,Marek Kozinski,Przemyslaw Magielski,Tomasz Fabiszak,Adam Sukiennik,Eliano Pio Navarese,Grazyna Odrowaz-Sypniewska,Jacek Kubica
Mediators of Inflammation , 2012, DOI: 10.1155/2012/250867
Abstract: Objective. To assess the value of C-reactive protein (CRP) in predicting postinfarct left ventricular remodelling (LVR). Methods. We measured in-hospital plasma CRP concentrations in patients with a first ST-segment elevation myocardial infarction (STEMI). Results. LVR was present at 6 months in 27.8% of 198 patients. CRP concentration rose during the first 24?h, mainly in LVR group. The prevalence of LVR was higher in patients from the highest quartile of CRP concentrations at 24?h as compared to those from any other quartile (odds ratio (OR) 3.48, 95% confidence interval (95% CI) 1.76–6.88). Multivariate analysis identified CRP concentration at 24?h (OR for a 10?mg/L increase 1.29, 95% CI?1.04–1.60), B-type natriuretic peptide at discharge (OR for a 100?pg/mL increase 1.21, 95% CI?1.05–1.39), body mass index (OR for a 1?kg/m2 increase 1.10, 95% CI?1.01–1.21), and left ventricular end-diastolic volume (OR for a 1?mL increase 0.98, 95% CI?0.96-0.99) as independent predictors of LVR. The ROC analysis revealed a limited discriminative value of CRP (area under the curve 0.61; 95% CI?0.54–0.68) in terms of LVR prediction. Conclusions. Measurement of CRP concentration at 24?h after admission possesses a significant but modest value in predicting LVR after a first STEMI. 1. Introduction Left ventricular remodelling (LVR) often complicates acute ST-segment elevation myocardial infarction (STEMI) [1, 2]. The acute loss of myocardium results in an abrupt increase in loading conditions that induces LVR, the process by which ventricular size, shape, and function are regulated by mechanical, neurohormonal, and genetic factors [3]. Postinfarct LVR leads to a progressive rise in systolic and diastolic left ventricular volumes, distortion of ventricular shape and mural hypertrophy, in the weeks and months after STEMI [3]. It has been identified as an important marker of poor prognosis, linked with excessive cardiovascular mortality and risk of heart failure [1–4]. The major determinants of LVR after STEMI include infarct size, anterior location of infarction, and late or unsuccessful reperfusion therapy both at the epicardial artery level and at the microvascular level, transmurality of the infarct and extent of myocardial stunning [3–7]. Acute myocardial infarction (MI) is associated with a systemic inflammatory response with augmented production of nonspecific plasma acute-phase proteins, including C-reactive protein (CRP) [8]. The increase in plasma CRP concentration in the course of acute MI takes place in the first hours since the onset of symptoms and peaks
Galactomannan detection from piperacillin-tazobactam brands available in the Brazilian market
Xavier, Melissa Orzechowski;Pasqualotto, Alessandro Comarú;Aquino, Valério Rodrigues;Sukiennik, Teresa Cristina Teixeira;Severo, Luiz Carlos;
Brazilian Journal of Infectious Diseases , 2009, DOI: 10.1590/S1413-86702009000500007
Abstract: piperacillin-tazobactam is a broad spectrum antimicrobial agent that can cause false-positive results in the commercial platelia aspergillus eia test. so far, no study has been performed in latin america to evaluate the clinical implication of this finding. here we studied the potential for galactomannan detection in piperacillin-tazobactam batches commercialized in the brazilian market. five batches from distinct laboratories were tested in duplicate in the platelia aspergillus eia according to the manufacturer's instructions. only one drug showed crossreaction at a cut-off of 0.5. human serum was spiked with this particular drug aiming to mimic achievable piperacillin-tazobactam concentrations in the serum. results were all negative for galactomannan detection, even at high drug concentrations. results from this pilot study suggest that piperacillin-tazobactam might not be a clinically significant cause of false-positive results in the platelia aspergillus eia test in brazil.
Thinking about Physicalism  [PDF]
Ricardo Restrepo
Open Journal of Philosophy (OJPP) , 2012, DOI: 10.4236/ojpp.2012.22012
Abstract: Physicalism, if it is to be a significant thesis, should differentiate itself from key metaphysical contenders which endorse the existence of platonic entities, emergent properties, Cartesian souls, angels, and God. Physicalism can never be true in worlds where things of these kinds exist. David Papineau, David Spurrett, and Barbara Montero have recently developed and defended two influential conceptions of physicalism. One is derived from a conception of the physical as the non-mentally-and-non-biologically identifiable. The other is derived from a conception of the physical as the non-sui-generis-mental. The paper looks at the resources available to those conceptions, but argues that each is insufficient to yield a conception of physicalism that differentiates it from key anti-physicalist positions. According to these conceptions, if we lived in a world full of things that clearly cannot be physical, we would still live in a physical world. Thus, such conceptions of physicalism are of little theoretical interest.
Two Myths of Psychophysical Reductionism  [PDF]
Ricardo Restrepo
Open Journal of Philosophy (OJPP) , 2012, DOI: 10.4236/ojpp.2012.22011
Abstract: This paper focuses on two prominent arguments claiming that physicalism entails reductionism. One is Kim’s causal exclusion argument (CEA), and the other is Papineau’s causal argument. The paper argues that Kim’s CEA is not logically valid and that it is driven by two implausible justifications. One is “Edward’s dictum”, which is alien to non-reductive physicalism and should be rejected. The other is by endorsement of Papineau’s conception of the physical, immanent in Papineau’s causal argument. This argument only arrives at the physical property-property identities by using a conception of the physical that licenses anything to be reductively physical, including putative core anti-physical entities; thus, leaving Papineau’s causal argument and Kim’s CEA without a reductive physicalist conclusion of philosophical interest.
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