Assuntos
Viabilidade Fetal , Neonatologia/normas , Obstetrícia/normas , Guias de Prática Clínica como Assunto , Nascimento Prematuro/diagnóstico , Nascimento Prematuro/terapia , Alemanha , Humanos , Recém-Nascido , Neonatologia/ética , Neonatologia/legislação & jurisprudência , Obstetrícia/ética , Obstetrícia/legislação & jurisprudênciaRESUMO
Interaction of ultrashort laser pulses with materials can bring the latter to highly non-equilibrium states, where the electronic temperature strongly differs from the ionic one. The properties of such excited material can be considerably different from those in a hot, but equilibrium state. The reliable modeling of laser-irradiated target requires careful analysis of its properties in both regimes. This paper reports a procedure which provides the equations of state of ruthenium using density functional theory calculations. The obtained data are fitted with analytical functions. The constructed equations of state are applicable in the one- and two-temperature regimes and in a wide range of densities, temperatures and pressures. The electron thermal conductivity and electron-phonon coupling factor are also calculated. The obtained analytical expressions can be used in two-temperature hydrodynamics modeling of Ru targets pumped by ultrashort laser pulses. The data is related to the research article "Similarity in ruthenium damage induced by photons with different energies: From visible light to hard X-rays" [1].
RESUMO
BACKGROUND: With regard to medical decisions and measures at the end of life, the values and attitudes of those concerned are crucial. However, they have hardly been taken into account so far in German empirical studies on euthanasia and medical advance directives. METHOD: Between October 2003 and May 2004, a mail survey of a representative group of internists, anaesthetists and general practitioners from Bavaria, Westphalia-Lippe and Thuringia was conducted. RESULTS: Of 1,557 mailed questionnaires 727 were returned (rate of returns: 46 %). The survey showed, high of appreciation for medical advance directives and, at the same, time scepticism regarding surrogate decision-making by legal guardians and authorized representatives. Furthermore, the survey revealed a considerable amount of uncertainty in the physicians about the application of certain measures at the end of life to the different forms of euthanasia. In practice, many physicians do not comprehend the juridical differentiation between (illegal) active and (legal) passive or indirect euthanasia. CONCLUSIONS: In training and further education more scope should be given to the reflection of medical decisions at the end of life. At the same time, the usual, partly counterintuitive legal definitions should be brought more into line with medical decision making, while taking into account developments in English speaking areas. A transdisciplinary discourse is indispensable for the development of medical ethical and legal justifications suitable as guidance for action.
Assuntos
Diretivas Antecipadas/psicologia , Atitude do Pessoal de Saúde , Eutanásia/psicologia , Papel do Médico/psicologia , Adulto , Diretivas Antecipadas/ética , Diretivas Antecipadas/legislação & jurisprudência , Anestesiologia , Coleta de Dados , Ética Médica , Eutanásia/ética , Eutanásia/legislação & jurisprudência , Medicina de Família e Comunidade , Feminino , Alemanha , Humanos , Medicina Interna , Masculino , Futilidade Médica/ética , Futilidade Médica/legislação & jurisprudência , Futilidade Médica/psicologia , Pessoa de Meia-IdadeRESUMO
The influence of xantinol-nicotinate (Complamin) or with its chemical designation 7-[2-hydroxy-3-(N-2-hydroxy-ethyl-N-methylamino) propyl]-1,3-dimethylxanthinepyridine-3-carboxylate and its formula: C19H26N6O6, on 2500 tissue cultures of embrynic epithelium, bone and connective tissues from the domestic chicken was examined. It was found that xantine-nicotinate at high concentrations strongly inhibits cell proliferation. It seems possible that this substance is insolubly bound to the nucleic acids. With the diminution of the concentration to values corresponding those in the human organism, the stimulation effects on mitosis and cell proliferation were striking, in bone and connective tissues stronger than in the epithelial tissues. In tissue culture there appeared eventually remarkable effects with very high doses not applied in human medicine.
Assuntos
Osso e Ossos/embriologia , Tecido Conjuntivo/embriologia , Epitélio/embriologia , Teofilina/análogos & derivados , Niacinato de Xantinol/farmacologia , Animais , Osso e Ossos/efeitos dos fármacos , Divisão Celular/efeitos dos fármacos , Embrião de Galinha , Tecido Conjuntivo/efeitos dos fármacos , Vasos Coronários/efeitos dos fármacos , Vasos Coronários/embriologia , Técnicas de Cultura , Epitélio/efeitos dos fármacos , Coração/embriologia , Fígado/embriologia , Pulmão/efeitos dos fármacos , Pulmão/embriologia , Mitose/efeitos dos fármacos , Pele/embriologia , Coluna Vertebral/embriologia , Língua/embriologiaRESUMO
Seventy-seven major thermal injury victims were studied with a number of hematologic and immunologic tests initially and sequentially during the first postburn month. The patients were grouped by initial prognostic index as well as by ultimate survival. Pairs were grouped by initial prognostic index as well as by ultimate survival. Pairs of test data from subjects studied at successive time intervals were compared with prognostic index and ultimate survival. Statistically significant changes in coagulation, fibrinolytic, complement, and kinin tests all occurred within these groups. These findings strongly suggest that intravascular contamination occurs following thermal injury in proportion to the extent of the burn, because of the occurrence and persistence of statistically significant multiple system changes. Regrouping all of the blood data according to ultimate death or survival reinforced the concept of intravascular contamination and provided the basis by which one can compute laboratory prognostic indices. The combination of plasminogen, C'3 complement, C'H50, one-minute kinin, and TEG index discriminated between death and survival with 91% accuracy by the end of the first postburn week. These data offer the potential for select blood measurements in refining current prognostic indicators. This may provide an objective data base for the analysis of new treatment programs in thermal injury victims.