Biblioteca Digital

OBJECTIVE: To verify the prevalence of acute hyperglycemia in children with head trauma stratified by the Glasgow coma scale (GCS). METHOD: A prospective cross-sectional study carried out with information from medical records of pediatric patients presenting with head injury in the emergency room of a referral emergency hospital during a one year period. We considered the cut-off value of 150 mg/dL to define hyperglycemia. RESULTS: A total of 340 children were included and 60 (17.6%) had admission hyperglycemia. Hyperglycemia was present in 9% of mild head trauma cases; 30.4% of those with moderate head trauma and 49% of severe head trauma. We observed that among children with higher blood glucose levels, 85% had abnormal findings on cranial computed tomography scans. CONCLUSION: Hyperglycemia was more prevalent in patients with severe head trauma (GCS <8), regardless if they had or not multiple traumas and in children with abnormal findings on head computed tomography scans.; OBJETIVO: Verificar a prevalência de hiperglicemia aguda em crianças vítimas de trauma craniencefálico, de acordo com a escala de coma de Glasgow (GCS). MÉTODO: Estudo prospectivo, de corte transversal realizado por meio do acompanhamento de prontuários médicos de pacientes na faixa etária pediátrica admitidos na unidade de urgência de um hospital de referência vítimas de traumatismo craniencefálico...

The design of a lateral line for drip irrigation requires accurate evaluation of head losses in not only the pipe but in the emitters as well. A procedure was developed to determine localized head losses within the emitters by the formulation of a mathematical model that accounts for the obstruction caused by the insertion point. These localized losses can be significant when compared with tire total head losses within the system due to the large number of emitters typically installed along the lateral line. Air experiment was carried out by altering flow characteristics to create Reynolds numbers (R) from 7,480 to 32,597 to provide turbulent flow and a maximum velocity of 2.0 m s(-1). The geometry of the emitter was determined by an optical projector and sensor An equation was formulated to facilitate the localized head loss calculation using the geometric characteristics of the emitter (emitter length, obstruction ratio, and contraction coefficient). The mathematical model was tested using laboratory measurements on four emitters. The local head loss was accurately estimated for the Uniram (difference of +13.6%) and Drip Net (difference of +7.7%) emitters, while appreciable deviations were found for the Twin Plus (-21.8%) and Tiran (+50%) emitters. The head loss estimated by the model was sensitive to the variations in the obstruction area of the emitter However...

A inserção de gotejadores em uma tubulação modifica as linhas de fluxo, provocando turbulência local, que resulta em perdas de carga adicionais maiores que as perdas contínuas na tubulação. Para avaliar a perda total de carga, ao longo da linha lateral de gotejadores, as perdas contínuas e as localizadas, devidas à presença dos emissores no tubo, devem ser consideradas. Este trabalho apresenta os resultados de um experimento conduzido para avaliar as perdas localizadas de carga em gotejadores coaxiais integrados em tubos de polietileno. A perda de carga para diferentes vazões foi determinada em quatro modelos de tubos gotejadores, com sete repetições. Cada segmento de tubo utilizado continha 11 gotejadores. Para cada vazão, a perda localizada de carga foi calculada pela diferença entre a perda de carga no tubo com emissor e a perda de carga continua no tubo uniforme, estimada pela equação de Darcy-Weisbach. Aproximações matemáticas foram sugeridas para calcular a perda de carga com base no coeficiente de carga cinética (K) e em um valor constante de comprimento equivalente (Le). Para cada modelo de tubo gotejador, o coeficiente K foi praticamente independente do número de Reynolds, para R > 10 000, sugerindo que cada gotejador pode ser caracterizado por um valor médio de K...

Sistemas de irrigação geralmente são dimensionados negligenciando-se os cálculos das perdas localizadas de carga, o que muitas vezes causa desbalanço hidráulico deste sistema. A irrigação localizada possui muitas peças especiais para as quais, muitas vezes, não existem equações matemáticas que possibilitem o cálculo destas perdas. Este trabalho teve como objetivo o ajuste de equações que permitam o cálculo da perda localizada de carga para a passagem direta e outra para a passagem lateral, causada pela presença de conectores iniciais de linha. A perda de carga na passagem direta é causada pela área da protrusão do conector internamente à tubulação e a perda de carga na passagem lateral é causada pela mudança no perfil de escoamento da água ao passar pelo conector. Para as duas situações a perda localizada no conector foi obtida por diferença entre a perda distribuída de carga no tubo mais conector e a perda distribuída de carga no tubo sem conector. Foram utilizados 5 conectores em 5 diâmetros de tubulação de polietileno e 3 diâmetros de tubulação de PVC. Foi utilizada análise dimensional para o desenvolvimento das equações que para a passagem direta apresentou um coeficiente de determinação de 97...

As discussões sobre a interdisciplinaridade não são recentes e, apesar de haver controvérsias quanto ao seu significado, está bastante difundida e aceita nos meios científicos e pedagógicos, nas universidades e escolas, desde as últimas décadas do século XX, sendo proposta como um dos princípios pedagógico-científicos fundamentais em muitos cursos e/ou reformas curriculares na busca de soluções para diversos problemas educacionais. Apesar disso, permanecem dúvidas acerca de como ela tem sido entendida pelos profissionais de ensino, se ela tem sido mesmo posta em prática e sob que formato. A partir daí, os objetivos que orientam esta pesquisa são: compreender o lugar ocupado pela interdisciplinaridade no Curso de Gestão Educacional (CEGE) promovido pela Faculdade de Educação da Unicamp, especificamente no componente curricular de Ciências; analisar a interpretação que os gestores possuem sobre o potencial interdisciplinar das idéias-chave do currículo proposto por este componente curricular; identificar e discutir as manifestações e representações de interdisciplinaridade contidas no discurso dos gestores participantes do CEGE. Trata-se de um estudo de características predominantemente quantitativas, abrangendo uma amostra de 186 trabalhos de conclusão da Disciplina "Gestão Currículo e Cultura"...

Aims: Neck pain is a common complaint and accounts for a significant proportion of individuals seeking physiotherapy. Assessment for patients with neck pain normally involves a judgment of head posture. Head posture is considered important as deviations from ‘normal’ may have detrimental biomechanical and physiological implications and provide clues as to optimal interventions. However, studies comparing head posture between patients with neck pain and asymptomatic individuals have shown conflicting results. This article critically appraises the role of head posture assessment for patients with neck pain. Methods: The rationale for a relationship between head posture and neck pain is discussed; clinical assessment of head posture—including issues around surrogate measures, validity and reliability—is explored, and studies comparing patients with neck pain and asymptomatic individuals are examined. Finally, studies investigating techniques to correct head posture are appraised. Findings and conclusions: It is unclear whether the assessment of head posture through observation is valid and/or reliable and whether therapeutic interventions to improve head posture result in gains for the patient. There is a need for further research exploring the links between these factors...

OBJECTIVES: Patients with Type I neurofibromatosis scoliosis with intra-canal rib head protrusion are extremely rare. Current knowledge regarding the diagnosis and treatment for this situation are insufficient. The purpose of this study is to share our experience in the diagnosis and surgical treatments for such unique deformities. METHODS: Six patients with Type I neurofibromatosis scoliosis with rib head dislocation into the spinal canal were diagnosed at our institution. Posterior instrumentation and spinal fusion without intra-canal rib head resection via a posterior-only approach was performed for deformity correction and rib head extraction. The efficacy and outcomes of the surgery were evaluated by measurements before, immediately and 24 months after the surgery using the following parameters: coronal spinal Cobb angle, apex rotation and kyphosis of the spine and the intra-canal rib head position. Post-operative complications, surgery time and blood loss were also evaluated. RESULTS: Patients were followed up for at least 24 months post-operatively. The three dimensional spinal deformity was significantly improved and the intra-canal rib head was significantly extracted from the canal immediately after the surgery. At follow-up 24 months after surgery...

The objective of the present study is to characterize genitourinary tumors (GU) metastatic to the head and neck and to determine long-term prognoses. Using a retrospective chart review of 734 patients treated between January 1995 and May 2005 with an ICD-9 code pertaining to a metastatic head and neck cancer, we found 37 patients with primary GU tumors. There were 24 cases of prostate cancer, 10 cases of renal cell carcinoma, and 4 cases of transitional cell carcinoma. Sixteen of 24 patients (67%) with prostate cancer had a cranial metastasis while 6 of 9 (67%) patients with renal cell carcinoma had cerebral metastasis. We concluded that prolonged survival is possible in prostate cancer patients treated aggressively with radiation and chemotherapy, indicating that early detection and aggressive screening are important in these patients.

Although head CT is often routinely performed in emergency department (ED) patients with syncope, few studies have assessed its value. Objectives: To determine the yield of routine head CT in ED patients with syncope and analyse the factors associated with a positive CT. Methods: Prospective, observational, cohort study of consecutive patients presenting with syncope to an urban tertiary-care ED (48 000 annual visits). Inclusion criteria: age >8 and loss of consciousness (LOC). Exclusion criteria included persistent altered mental status, drug-related or post-trauma LOC, seizure or hypoglycaemia. Primary outcome was abnormal head CT including subarachnoid, subdural or parenchymal haemorrhage, infarction, signs of acute stroke and newly diagnosed brain mass. Results: Of 293 eligible patients, 113 (39%) underwent head CT and comprise the study cohort. Ninety-five patients (84%) were admitted to the hospital. Five patients, 5% (95% CI=0.8%–8%), had an abnormal head CT: 2 subarachnoid haemorrhage, 2 cerebral haemorrhage and 1 stroke. Post hoc examination of patients with an abnormal head CT revealed focal neurologic findings in 2 and a new headache in 1. The remaining 2 patients had no new neurologic findings but physical findings of trauma (head lacerations with periorbital ecchymoses suggestive of orbital fractures). All patients with positive findings on CT were >65 years of age. Of the 108 remaining patients who had head CT...

Corporate head offices serve as the figureheads and decision-making cores of firms. For a variety of reasons, these head offices tend to locate in major cities. Cities themselves compete to attract head offices for their presumed positive economic impact, but what is the impact? Calgary, Alberta, is Canada’s energy centre and an emerging leader in head office counts that is expected to further grow its share of Canadian corporate head offices. This report seeks to estimate the economic impact of an oil and gas (O&G) firm relocating to Calgary, AB. Based on decades of theory and using data from a variety of sources, two multipliers are calculated: the economic base multiplier and the H.C. Davis income multiplier. By applying these multipliers to data regarding head office employment and O&G industry wages, estimates of the employment and income effects of the relocation are found. The results emphasize the importance of both the O&G industry and attracting head offices to Calgary. Based on these conclusions, two key policy avenues are recommended to encourage further expansion of Calgary’s head office counts.

Client-directed long-term rehabilitative goals and life satisfaction following head injury emphasize the importance of social inclusion, rather than cognitive or physical, outcomes. However, very little research has explored the socio-emotional factors that pose as barriers to social reintegration following injury. This study investigates social barriers following head injury (i.e., decision-making - Iowa Gambling Task [IGT] and mood – depression) and possible amelioration of those challenges (through treatment) in both highly functioning university students with and without mild head injury (MHI) and in individuals with moderate traumatic brain injury (TBI). An arousal manipulation using emotionally evocative stimuli was introduced to manipulate the subject’s physiological arousal state. Seventy-five university students (37.6% reporting a MHI) and 11 patients with documented moderate TBI were recruited to participate in this quasi-experimental study. Those with head injury were found to be physiologically underaroused (on measures of electrodermal activation [EDA] and pulse) and were less sensitive to the negative effects of punishment (i.e., losses) in the gambling task than those without head injury, with greater impairment being observed for the moderate TBI group. The arousal manipulation...

Ten head impacts between pedestrians and cars were reconstructed to compare the head injuries sustained by pedestrians with the results of reconstruction tests using the headform impactors designated by the European Enhanced Vehicle-safety Committee (EEVC) Working Group 10 for assessing pedestrian head protection. The methodology of this study included at-scene accident investigation, computer simulation, and physical reconstruction in a laboratory of the head impacts that occurred in the accident cases that were investigated. The main finding was that the results from using the EEVC headform impactors test correlate well with the severity of any head injury, as measured by the Abbreviated Injury Scale, in actual pedestrian accidents. Head impacts that exceeded a HIC value of 1000 were positively associated with head injuries that were AIS3 or above.; Robert Anderson, Luke Streeter, Giulio Ponte, Marleen Van de Griend, Tori Lindsay, Jack McLean; Copyright © 2003 Inderscience Enterprises Limited. All rights reserved.

Objective: To explore rates of hospitalized head injury among older Australians by a range of risk indicators. Design: Head injury data for 60+-year-olds were obtained from the Australian Institute of Health and Welfare Hospital Morbidity Database from 1998/1999 to 2004/2005. Poisson regression modeling was used to examine head injury rates in relation to age, sex, Indigenous status, location, and injury type. Results: Rates of hospitalized head injury among the older population increased 1.4-fold between 1998/1999 (582.8 per 100 000) and 2004/2005 (844.3 per 100 000) (p<0.001). Those aged 85+ years had 10.8 times the rate of their 60–64-year-old counterparts (95% CI 10.6 to 11.0) after adjustment for other covariates. Men had 1.1 times the rate of women (95% CI 1.1 to 1.2), and those living in rural/remote areas had 3.1 times the rate of their metropolitan-dwelling counterparts (95% CI 3.0 to 3.1). Those identifying themselves as Indigenous had 1.7 times the rate of non-Indigenous persons (95% CI 1.6 to 1.8). The most prevalent injuries were open wounds of the head (38.0%), followed by superficial injuries (24.7%) and intracranial trauma (18.3%). Falls accounted for 81.4% of all head injury admissions. Conclusions: The oldest old were disproportionately represented among those sustaining hospitalized head injuries...

Objective: To determine the effects of head position and of different postural control demands on head tremor measures in participants with essential tremor. Methods: Seventeen participants with essential tremor (ET) of the head and 17 control participants took part. Individuals held their heads in varying degrees of rotation, flexion, and extension. Subsequently, individuals sat and stood in different postures, incorporating different foot placements (feet apart and together), surfaces (solid and foam), and vision conditions (eyes open and closed). Neck muscle activity was recorded from three muscles bilaterally (trapezius, sternocleidomastoid, splenius capitis). Three-dimensional head and thorax positions were recorded using an Optotrak system, and head angular velocity with respect to thorax was calculated by differentiating tilt-twist angles. Fourier analysis was used to determine tremor power. Results: ET participants showed sharp peaks at their tremor frequency in spectral plots of kinematic data, whereas CN participants did not. Electromyography data was too noisy for frequency analysis. ET participants displayed increased tremor power in head positions 25° from neutral compared to neutral and positions 50° from neutral. Tremor power increased with increasing difficulty of posture for both participant groups. Removal of vision resulted in decreased tremor power in ET participants; power was significantly decreased in the easier postures...

Walking pigeons display a characteristic behaviour: head-bobbing. Head-bobbing consists of two phases, the hold phase during which the head is kept stable in space, and the thrust phase during which the head is quickly moved forward. But why do pigeons and so many other birds head-bob? Two theories have been developed to answer this question. First, head-bobbing may have a visual function, namely object detection during the hold phase and depth perception during the thrust phase. Second, head-bobbing may have the biomechanical function of increasing the stability. The present study aimed to gain further insight into why pigeons head-bob. A gait cycle analysis of walking pigeons revealed that the hold phase starts at a specific point in the gait cycle and is not dependent on the walking speed. The point in the gait cycle at which the hold phase starts indicates a potential increase in stability during the single stance phase, as it leads to a longer period of time during which the center of mass is above the base of support. The end of the hold phase, however, is dependent on the walking speed, specifically the step length for a given walking speed. I found that the thrust phase duration is constant for all walking speeds and the distance the head travels during that time is equal to the step length. With increasing walking speed the head moves faster during the thrust phase and the hold phase duration is decreased leading to a higher head-bobbing frequency. With fast enough walking speed the hold phase is eventually eliminated...

This paper explains the effect of a motion platform for driving simulators on postural instability and head vibration exposure. The sensed head level-vehicle (visual cues) level longitudinal and lateral accelerations (ax,sensed = ax_head and ay,sensed = ay_head, ayv = ay_veh and ayv = ay_veh) were saved by using a motion tracking sensor and a simulation software respectively. Then, associated vibration dose values (VDVs) were computed at head level during the driving sessions. Furthermore, the postural instabilities of the participants were measured as longitudinal and lateral subject body centre of pressure (XCP and YCP, respectively) displacements just after each driving session via a balance platform. The results revealed that the optic-head inertial level longitudinal accelerations indicated a negative non-significant correlation (r = −.203, p = .154 > .05) for the static case, whereas the optic-head inertial longitudinal accelerations depicted a so small negative non-significant correlation (r = −.066, p = .643 > .05) that can be negligible for the dynamic condition. The XCP for the dynamic case indicated a significant higher value than the static situation (t(47), p < .0001). The VDVx for the dynamic case yielded a significant higher value than the static situation (U(47)...

Este trabalho foi desenvolvido com o objetivo de ajustar equações que estimam a perda distribuída de carga em microtubos utilizados em microaspersão e a perda localizada de carga na passagem lateral do fluxo por meio dos conectores na linha lateral. A perda distribuída de carga foi determinada em quatro diâmetros de microtubos com nove a dez repetições para 15 vazões, por meio da aplicação do teorema de Bernoulli. O fator de atrito (f) foi estimado fixando-se o valor de m = 0,25 e calibrando-se o valor do parâmetro c (0,290). A perda localizada de carga foi determinada por diferença entre perda de carga no microtubo mais conector e perda de carga no microtubo. Dois modelos de conectores foram utilizados e caracterizados quanto ao diâmetro interno e dimensões. Uma aproximação matemática foi proposta para calcular a perda localizada de carga com base em coeficiente de carga cinética do conector (K'), que leva em consideração as dimensões do conector e do microtubo e independência das forças viscosas para Re > 5.000. As variações de vazão e de pressão entre os emissores situados nos extremos da linha lateral mostraram-se sensíveis à perda de carga na passagem lateral pelo conector mais a perda de carga no microtubo.; This work was carried out aimed at presenting equations to estimate the continuous head loss in microtubes and the local head loss in the connector used on microsprinklers lateral lines. The continuous head loss was determined using Bernoulli's theorem for four microtubes diameters...

Objective The objective of the study was to assess the lifetime prevalence and validity of self-reported head injury. Study design and setting Analysis of a cross-sectional community survey, stratified by birth cohort. Seven thousand four hundred eighty-eight residents of Canberra and Queanbeyan, 3,678 males and 3,810 females, representing three cohorts aged in their 20s, 40s and 60s at the time of the survey, were randomly selected from the Australian Electoral Roll. Results The lifetime prevalence of head injury with at least 15 min loss of consciousness ranged from 5.6 to 6.0% across the three cohorts. Self-reported head injury was associated with symptoms of traumatic brain injury or postconcussion syndrome. Reported head injury did not differ across the birth cohorts, contrary to expectations that prevalence rates would increase with age. Analysis of age at first head injury showed significant differences between cohorts in the reported prevalence at age 20, with estimates considerably higher for the youngest cohort. Conclusion Although the data may reflect real increases in the risk of head injury, it may be that self-reported measures of lifetime prevalence of head injury underestimate prevalence in older cohorts.

Este estudo analisou prospectivamente a gravidade do Traumatismo Crânio-Encefálico (TCE) a partir de índices anatômicos e fisiológicos em pacientes internados em Unidade de Terapia Intensiva. Teve por objetivo caracterizar a população quanto a idade, sexo, tempo de permanência na UTI e causa externa. Caracterizar a gravidade das lesões pela Abbreviated Injury Scale (AIS), do trauma pelo Injury Severity Score (ISS) e do TCE pela Escala de Coma de Glasgow (ECGl), além de verificar a possível associação entre os índices. Os resultados apontam a predominância de adultos jovens e do sexo masculino com causa externa mais freqüente em acidentes de trânsito de veículo a motor e média de permanência na UTI de 6,28 dias. Quanto a gravidade das lesões constatou-se que os pacientes apresentaram lesões graves, que não ameaçam a vida (AIS3) e lesões graves, que ameaçam a vida (AIS4) e que a região corpórea mais atingida foi a cabeça e pescoço. Em relação a gravidade do trauma constatou-se que a maioria dos pacientes obteve ISS 3 16. Pela gravidade do TCE, a maioria dos pacientes apresentou TCE grave ou ECGl de 3 a 8. Através da associação entre os índices analisados por grupos de gravidade constatou-se que há associação estatisticamente significativa entre a ECGl-1 e a AIS da região cabeça...