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1.
PLoS Biol ; 16(11): e3000039, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30422973

RESUMO

Pauchard et al claim that non-native species should not be granted conservation value, as this could hinder effort to curtail novel introductions. In this response, Schlaepfer counters that the positive contributions of non-native species to biodiversity and conservation must be included to provide a complete and objective snapshot to policy makers.


Assuntos
Conservação dos Recursos Naturais , Espécies Introduzidas , Biodiversidade
2.
Rom J Anaesth Intensive Care ; 25(2): 97-101, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30393765

RESUMO

Study objective: Videolaryngoscopes can be fitted either with channeled or non-channeled blades, which may result in a different performance and success of tracheal intubation. We investigated the characteristics of the two different blade types of the commercially available KingVision™ videolaryngoscope. Design: A prospective, randomized, single center investigation study in a urological operation unit of a tertiary hospital. Subjects and Methods: Forty adult patients undergoing elective urological surgery in general anaesthesia with tracheal intubation were randomly allocated into group 1 (channeled videolaryngoscopy, n = 20) and group 2 (non-channeled videolaryngoscopy, n = 20). We measured the times from laryngoscope insertion to recognize the glottis and to conclude tracheal intubation. The number of laryngoscopy/intubation attempts and the degree of visual glottis exposure on a visual analog scale from 0 (glottis not visible) to 10 (glottis fully visible) was assessed. The lowest SpO2 value during airway management was recorded. Results: There was no statistically significant difference in biometric data between the 2 groups. The time from the laryngoscope insertion to glottis recognition with the non-channeled blades was 5 (4-8) s as compared to the channeled ones with 11 (7-14) s (median and range; p = 0.01). Intubation duration was shorter with the channeled blades 17 (12-27) s vs. 29 (25-51) s (median and range; p < 0.001). Number of laryngoscopy/intubation attempts, grades for glottis visibility, intubation difficulty were not different. The lowest SpO2 was 98% in both groups. Conclusions: Videolaryngoscopic glottis recognition time was longer and the total time to secure the airway was shorter with the channeled blades.

3.
J Thorac Dis ; 10(6): 3845-3848, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30069385

RESUMO

Lung transplantation is an established therapeutic procedure for end stage lung diseases. Its success may be impaired by perioperative complications. Intraoperative blood loss and the resulting blood transfusion are among the most common complications. The various factors contributing to increased blood loss during lung transplantation are only scarcely investigated and not yet completely understood. This is in sharp contrast to other surgical fields, as in orthopedic surgery, liver transplantation and cardiac surgery the contributors to blood loss are well identified. This narrative review article aims to highlight the acknowledged factors influencing blood loss in lung transplantation (such as double vs. single lung transplant) and to discuss potential factors that may be of interest for further research or helpful to develop strategies targeting risk factors in order to minimize blood loss during lung transplantation and finally improve patient outcome.

4.
PLoS Biol ; 16(4): e2005568, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29664943

RESUMO

The Convention on Biological Diversity (CBD) emphasises the role of biodiversity in delivering benefits essential for all people and, as a result, seeks to safeguard all life-forms. The indices that are used to measure progress towards international conservation and sustainability goals, however, focus solely on the 'native' component of biodiversity. A subset of non-native species can cause undesirable economic, social, or biological effects. But non-native species also contribute to regional biodiversity (species richness and biotic interactions) and ecosystem services. In some regions and cities, non-native species make up more than half of all species. Currently, the contributions of these species to biodiversity and ecosystem services are overlooked. Here, I argue that biodiversity and sustainability indices should include all species. This is not only consistent with definitions of biodiversity but also will promote the idea that long-term, sustainable, human well-being is intricately tied to benefits derived from nature.


Assuntos
Biodiversidade , Conservação dos Recursos Naturais/métodos , Espécies Introduzidas/tendências , Animais , Ecossistema , Humanos , Plantas , Dinâmica Populacional/estatística & dados numéricos
5.
Eur J Anaesthesiol ; 33(12): 943-948, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27533711

RESUMO

BACKGROUND: Airway management in the emergency room can be challenging when patients suffer from life-threatening conditions. Mental stress, ignorance of the patient's medical history, potential cervical injury or immobilisation and the presence of vomit and/or blood may also contribute to a difficult airway. Videolaryngoscopes have been introduced into clinical practice to visualise the airway and ultimately increase the success rate of airway management. OBJECTIVE: The aim of this study was to test the hypothesis that the C-MAC videolaryngoscope improves first-attempt intubation success rate compared with direct laryngoscopy in patients undergoing emergency rapid sequence intubation in the emergency room setting. DESIGN: A randomised clinical trial. SETTING: Emergency Department of the University Hospital, Zurich, Switzerland. PATIENTS: With approval of the local ethics committee, we prospectively enrolled 150 patients between 18 and 99 years of age requiring emergency rapid sequence intubation in the emergency room of the University Hospital Zurich. Patients were randomised (1 : 1) to undergo tracheal intubation using the C-MAC videolaryngoscope or by direct laryngoscopy. INTERVENTIONS: Owing to ethical considerations, patients who had sustained maxillo-facial trauma, immobilised cervical spine, known difficult airway or ongoing cardiopulmonary resuscitation were excluded from our study. All intubations were performed by one of three very experienced anaesthesia consultants. MAIN OUTCOME MEASURES: First-attempt success rate served as our primary outcome parameter. Secondary outcome parameters were time to intubation; total number of intubation attempts; Cormack and Lehane score; inadvertent oesophageal intubation; ease of intubation; complications including violations of the teeth, injury/bleeding of the larynx/pharynx and aspiration/regurgitation of gastric contents; necessity of using further alternative airway devices for successful intubation; maximum decrease of oxygen saturation and technical problems with the device. RESULTS: A total of 150 patients were enrolled, but three patients had to be excluded from the analysis, resulting in 74 patients in the C-MAC videolaryngoscopy group and 73 patients in the direct laryngoscopy group. Tracheal intubation was achieved successfully at the first attempt in 73 of 74 patients in the C-MAC group and all patients in the direct laryngoscopy group (P = 1.0). Time to intubation was similar (32 ±â€Š11 vs. 31 ±â€Š9 s, P = 0.51) in both groups. Visualisation of the vocal cords, represented as the Cormack and Lehane score, was significantly better using the C-MAC videolaryngoscope (P < 0.001). CONCLUSION: Our study demonstrates that visualisation of the vocal cords was improved by using the C-MAC videolaryngoscope compared with direct laryngoscopy. Better visualisation did not improve first-attempt success rate, which in turn was probably based on the high level of experience of the participating anaesthesia consultants. TRIAL REGISTRATION: Clinicaltrials.gov identifier NCT02297113.


Assuntos
Serviço Hospitalar de Emergência , Intubação Intratraqueal/métodos , Laringoscópios , Laringoscopia/métodos , Cirurgia Vídeoassistida/métodos , Adulto , Idoso , Serviço Hospitalar de Emergência/normas , Feminino , Humanos , Intubação Intratraqueal/normas , Laringoscópios/normas , Laringoscopia/normas , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Tempo , Cirurgia Vídeoassistida/normas
6.
Resuscitation ; 105: 66-9, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27241333

RESUMO

INTRODUCTION: Airway management in the out-of-hospital emergency setting is challenging. Failed and even prolonged airway management is associated with serious clinical consequences, such as desaturation, bradycardia, airway injuries, or aspiration. The overall success rate of tracheal intubation ranges between 77% and 99%, depending on the level of experience of the provider. Therefore, advanced airway management should only be performed by highly-skilled and experienced providers. METHODS: 9765 patients were treated in the out-of-hospital emergency setting by the anaesthesiologist-staffed Helicopter Emergency Medical Services (HEMS) between 2002 and 2014. Patients successfully intubated upon the first attempt were compared to patients who required more than one intubation attempts regarding several potential confounding factors such as age, gender, on-going CPR, NACA Score, initial GCS, prior administration of anaesthetic drugs, neuromuscular blocking agents, and vasopressors. RESULTS: 1573 out of 9765 patients (16.1%) required advanced airway management. 459 patients had already been intubated upon arrival of the HEMS, whereas 1114 patients (11.4%) underwent advanced airway management by the HEMS physician. 67 patients had to be excluded. Data for the remaining 1047 patients (790 males and 257 females) were analyzed further. Primary use of an alternative airway device was reported in 59 patients (5.6%), whereas 988 patients (94.4%) underwent laryngoscopy-guided tracheal intubation. 952 patients (96.4%) could be intubated upon the first attempt and overall intubation success was 99.5% (983 out of 988). CONCLUSION: Our study demonstrates that HEMS physicians performed airway management frequently and that both the first attempt as well as the overall success rate of tracheal intubation was high. Together with the fact that all failed and difficult intubations were successfully recognized and handled and that no surgical airway had to be established, the current study once more underlines the importance of proper training of HEMS care providers regarding airway management.


Assuntos
Resgate Aéreo , Anestesiologistas/estatística & dados numéricos , Intubação Intratraqueal/estatística & dados numéricos , Adulto , Idoso , Anestésicos/uso terapêutico , Competência Clínica , Feminino , Humanos , Intubação Intratraqueal/efeitos adversos , Laringoscopia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Estatísticas não Paramétricas , Recursos Humanos
7.
PLoS One ; 11(5): e0155997, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27195693

RESUMO

INTRODUCTION: Sufficient ventilation and oxygenation through proper airway management is essential in patients undergoing cardio-pulmonary resuscitation (CPR). Although widely discussed, securing the airway using an endotracheal tube is considered the standard of care. Endotracheal intubation may be challenging and causes prolonged interruption of chest compressions. Videolaryngoscopes have been introduced to better visualize the vocal cords and accelerate intubation, which makes endotracheal intubation much safer and may contribute to intubation success. Therefore, we aimed to compare hands-off time and intubation success of direct laryngoscopy with videolaryngoscopy (C-MAC, Karl Storz, Tuttlingen, Germany) in a randomized, cross-over manikin study. METHODS: Twenty-six anesthesia residents and twelve anesthesia consultants of the University Hospital Zurich were recruited through a voluntary enrolment. All participants performed endotracheal intubation using direct laryngoscopy and C-MAC in a random order during ongoing chest compressions. Participants were strictly advised to stop chest compression only if necessary. RESULTS: The median hands-off time was 1.9 seconds in direct laryngoscopy, compared to 3 seconds in the C-MAC group. In direct laryngoscopy 39 intubation attempts were recorded, resulting in an overall first intubation attempt success rate of 97%, compared to 38 intubation attempts and 100% overall first intubation attempt success rate in the C-MAC group. CONCLUSION: As a conclusion, the results of our manikin-study demonstrate that video laryngoscopes might not be beneficial compared to conventional, direct laryngoscopy in easily accessible airways under CPR conditions and in experienced hands. The benefits of video laryngoscopes are of course more distinct in overcoming difficult airways, as it converts a potential "blind intubation" into an intubation under visual control.


Assuntos
Reanimação Cardiopulmonar/métodos , Intubação Intratraqueal/métodos , Laringoscopia/métodos , Cirurgia Vídeoassistida/métodos , Adulto , Reanimação Cardiopulmonar/normas , Estudos Cross-Over , Feminino , Humanos , Intubação Intratraqueal/normas , Laringoscopia/normas , Masculino , Manequins , Duração da Cirurgia , Distribuição Aleatória , Cirurgia Vídeoassistida/normas
8.
Resuscitation ; 102: 70-4, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26921473

RESUMO

BACKGROUND: Chest compressions and ventilation are lifesaving tasks during cardio-pulmonary resuscitation (CPR). Besides oxygenation, endotracheal intubation (ETI) during CPR is performed to avoid aspiration of gastric contents. If intubation is difficult or impossible, supraglottic airway devices are utilized. We tested six different airway devices regarding their potential to protect against regurgitation and aspiration during CPR in a randomized experimental human cadaver study. METHODS: Five-hundred ml of 0.01% methylene-blue-solution were instilled into the stomach of 30 adult human cadavers via an oro-gastric tube. The cadavers were then randomly assigned to one of six groups, resulting in 5 cadavers in each group. Airway management was performed with either bag-valve ventilation, Laryngeal Tube, EasyTube, Laryngeal Mask (Classic), I-Gel, or ETI. Thereafter 5min of CPR were performed according to the 2010 Guidelines of the European Resuscitation Council. Pulmonary aspiration was defined as the presence of methylene-blue-solution below the vocal cords or the ETI cuff as assessed by fiber-optic bronchoscopy. RESULTS: Thirty cadavers were included (14 females, 16 males). Aspiration was detected in three out of five cadavers receiving bag-valve ventilation and in two out of five intubated with LMA or I-Gel. In cadavers intubated with the LT, aspiration occurred in one out of five cases. No aspiration could be detected in cadavers intubated with ETI and EasyTube. CONCLUSION: This study provides experimental evidence that, during CPR, ETI offers superior protection against regurgitation and pulmonary aspiration of gastric contents than supraglottic airway devices or bag-valve ventilation.


Assuntos
Manuseio das Vias Aéreas/instrumentação , Reanimação Cardiopulmonar/métodos , Intubação Intratraqueal/instrumentação , Máscaras Laríngeas , Refluxo Laringofaríngeo/prevenção & controle , Pneumonia Aspirativa/prevenção & controle , Respiração Artificial/instrumentação , Adulto , Idoso , Idoso de 80 Anos ou mais , Cadáver , Desenho de Equipamento , Feminino , Parada Cardíaca/terapia , Humanos , Masculino , Manequins , Pessoa de Meia-Idade , Projetos Piloto
10.
PLoS One ; 6(12): e28444, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22205950

RESUMO

Dramatic declines and extinctions of amphibian populations throughout the world have been associated with chytridiomycosis, an infectious disease caused by the pathogenic chytrid fungus Batrachochytrium dendrobatidis (Bd). Previous studies indicated that Bd prevalence correlates with cooler temperatures in the field, and laboratory experiments have demonstrated that Bd ceases growth at temperatures above 28°C. Here we investigate how small-scale variations in water temperature correlate with Bd prevalence in the wild. We sampled 221 amphibians, including 201 lowland leopard frogs (Rana [Lithobates] yavapaiensis), from 12 sites in Arizona, USA, and tested them for Bd. Amphibians were encountered in microhabitats that exhibited a wide range of water temperatures (10-50°C), including several geothermal water sources. There was a strong inverse correlation between the water temperature in which lowland leopard frogs were captured and Bd prevalence, even after taking into account the influence of year, season, and host size. In locations where Bd was known to be present, the prevalence of Bd infections dropped from 75-100% in water <15°C, to less than 10% in water >30°C. A strong inverse correlation between Bd infection status and water temperature was also observed within sites. Our findings suggest that microhabitats where water temperatures exceed 30°C provide lowland leopard frogs with significant protection from Bd, which could have important implications for disease dynamics, as well as management applications.There must be quite a few things a hot bath won't cure, but I don't know many of them--Sylvia Plath, "The Bell Jar" (1963).


Assuntos
Anfíbios/microbiologia , Quitridiomicetos/patogenicidade , Temperatura Alta , Água/química , Anfíbios/fisiologia , Animais , Modelos Logísticos , Fatores de Tempo
11.
Ecotoxicology ; 20(7): 1599-608, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21688194

RESUMO

Mercury (Hg) deposited onto the landscape can be transformed into methylmercury (MeHg), a neurotoxin that bioaccumulates up the aquatic food chain. Here, we report on Hg concentrations in snapping turtles (Chelydra serpentina) across New York State, USA. The objectives of this study were to: (1) test which landscape, water, and biometric characteristics correlate with total Hg (THg) concentrations in snapping turtles; and (2) determine whether soft tissue THg concentrations correlate with scute (shell) concentrations. Forty-eight turtles were sampled non-lethally from ten lakes and wetlands across New York to observe patterns under a range of ecosystem variables and water chemistry conditions. THg concentrations ranged from 0.041 to 1.50 µg/g and 0.47 to 7.43 µg/g wet weight of muscle tissue and shell, respectively. The vast majority of mercury (~94%) was in the MeHg form. Sixty-one percent of turtle muscle samples exceeded U.S. Environmental Protection Agency (U.S. EPA) consumption advisory limit of 0.3 µg Hg/g for fish. Muscle THg concentrations were significantly correlated with sulfate in water and the maximum elevation of the watershed. Shell THg concentrations were significantly correlated with the acid neutralizing capacity (ANC) of water, the maximum elevation of the watershed, the percent open water in the watershed, the lake to watershed size, and various forms of atmospheric Hg deposition. Thus, our results demonstrate that THg concentrations in snapping turtles are spatially variable, frequently exceed advisory limits, and are significantly correlated with several landscape and water characteristics.


Assuntos
Mercúrio/análise , Compostos de Metilmercúrio/análise , Tartarugas , Poluentes Químicos da Água/análise , Animais , Ecossistema , Exposição Ambiental/análise , Monitoramento Ambiental/métodos , Cadeia Alimentar , Lagos , New York
12.
Conserv Biol ; 25(3): 428-37, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21342267

RESUMO

Non-native species can cause the loss of biological diversity (i.e., genetic, species, and ecosystem diversity) and threaten the well-being of humans when they become invasive. In some cases, however, they can also provide conservation benefits. We examined the ways in which non-native species currently contribute to conservation objectives. These include, for example, providing habitat or food resources to rare species, serving as functional substitutes for extinct taxa, and providing desirable ecosystem functions. We speculate that non-native species might contribute to achieving conservation goals in the future because they may be more likely than native species to persist and provide ecosystem services in areas where climate and land use are changing rapidly and because they may evolve into new and endemic taxa. The management of non-native species and their potential integration into conservation plans depends on how conservation goals are set in the future. A fraction of non-native species will continue to cause biological and economic damage, and substantial uncertainty surrounds the potential future effects of all non-native species. Nevertheless, we predict the proportion of non-native species that are viewed as benign or even desirable will slowly increase over time as their potential contributions to society and to achieving conservation objectives become well recognized and realized.


Assuntos
Conservação dos Recursos Naturais/métodos , Espécies Introduzidas , Biodiversidade , Ecossistema , Extinção Biológica , Cadeia Alimentar , Dinâmica Populacional
14.
Conserv Biol ; 20(1): 56-64, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16909659

RESUMO

Several international conservation organizations have recently produced global priority maps to guide conservation activities and spending in their own and other conservation organizations. Surprisingly, it is not possible to directly evaluate the relationship between priorities and spending within a given organization because none of the organizations with global priority models tracks how they spend their money relative to their priorities. We were able, however to evaluate the spending patterns of five other large biodiversity conservation organizations without their own published global priority models and investigate the potential influence of priority models on this spending. On average, countries with priority areas received greater conservation investment; global prioritization systems, however explained between only 2 and 32% of the U.S. dollars 1.5 billion spent in 2002, depending on whether the United States was removed from analyses and whether conservation spending was adjusted by the per capita gross domestic product within each country. We also found little overlap in the spending patterns of the five conservation organizations evaluated, suggesting that informal coordination or segregation of effort may be occurring. Our results also highlight a number of potential gaps and mismatches in how limited conservation funds are spent and provide the first audit of global conservation spending patterns. More explicit presentation of conservation priorities by organizations currently withoutpriority models and better tracking of spending by those with published priorities are clearly needed to help make future conservation activities as efficient as possible.


Assuntos
Conservação dos Recursos Naturais/economia , Sistemas de Informação Geográfica , Cooperação Internacional , Animais , Biodiversidade , Custos e Análise de Custo , Feminino , Internacionalidade , Masculino , Análise de Regressão
16.
Oecologia ; 137(2): 304-11, 2003 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-12883988

RESUMO

As humans extend their influence to an increasingly large portion of the globe, it becomes of both theoretical and practical interest to understand the consequences of our activities on wildlife populations. Norops polylepis is a small anoline lizard native to rainforest of southern Costa Rica. It is also found and known to lay eggs in cattle pastures immediately adjacent to forest. I predicted that N. polylepis eggs would fare poorly in pastures because of the important abiotic and biotic differences with their native forest habitat. I obtained eggs from captive females and estimated an egg's probability of hatching, daily survival rate, and incubation time at various distances along a forest-to-pasture gradient. Contrary to expectation, egg survival rates were higher in pastures than in forest areas. Furthermore, egg incubation times were significantly shorter in pastures than in their native forest. As a result, eggs were at least as likely to hatch in pastures as in forested areas. Thus, pastures may represent a benign or even beneficial habitat for the eggs of some reptile species. High survival of eggs will facilitate range expansion into human-altered habitats such as pastures, but does not guarantee it. Indeed, pastures could represent an ecological trap and a population sink if adults are drawn there (e.g., in search of favorable ovipositioning sites) yet suffer higher mortality than in forests.


Assuntos
Lagartos , Oviposição , Óvulo , Árvores , Agricultura , Animais , Bovinos , Conservação dos Recursos Naturais , Meio Ambiente , Humanos , Dinâmica Populacional , Análise de Sobrevida
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