Conduta de enfermagem na identificação de sinais e sintomas de fratura de base de crânio e a redução de impactos / Nursing conduct in the identification of skull base fracture signs and symptoms and the impact reduction

The use of fossil fuels as energy sources has grown to significantly be likely to have a major environmental impact. Reduction of world oil reserves and increasing environmental concerns have prompted alternative is found and renewable source of energy called biodiesel. Biodiesel fuel from vegetable oil is considered as the best candidates for diesel fuel replacement in diesel engines because of its closer. Fuel prices are going up day by day in the world. Thus, the means and methods have been trying for years to get fuel alternative outcomes. This study investigated the effects of different storage periods used in quality biodiesel blends (B5, B10, B15) of waste cooking oil and diesel fuel under low temperature and the temperature of the environment. Biodiesel samples were stored in glass containers under indoor conditions, and outdoor conditions for 10 weeks in total. These samples were monitored on a weekly basis through the test properties. The experimental density, viscosity, acid value, water content and flash point discussed in detail. Biodiesel storage at low temperatures is suitable and more advantageous because the impact on the physical properties is minimal and beneficial to slow down the degradation of biodiesel and storage.

Download Full-text

Environmental potential of carbon dioxide utilization in the polyurethane supply chain

Faraday Discussions ◽

10.1039/c5fd00067j ◽

2015 ◽

Vol 183 ◽

pp. 291-307 ◽

Cited By ~ 33

Author(s):

Niklas von der Assen ◽

André Sternberg ◽

Arne Kätelhön ◽

André Bardow

Keyword(s):

Carbon Dioxide ◽

Supply Chain ◽

Environmental Impacts ◽

Environmental Benefits ◽

Supply Chain Optimization ◽

Environmental Evaluation ◽

Impact Reduction ◽

Carbon Dioxide Utilization ◽

Systematic Exploration ◽

The Impact

Potential environmental benefits have been identified for the utilization of carbon dioxide (CO2) as a feedstock for polyurethanes (PUR). CO2 can be utilized in the PUR supply chain in a wide variety of ways ranging from direct CO2 utilization for polyols as a PUR precursor, to indirect CO2 utilization for basic chemicals in the PUR supply chain. In this paper, we present a systematic exploration and environmental evaluation of all direct and indirect CO2 utilization options for flexible and rigid PUR foams. The analysis is based on an LCA-based PUR supply chain optimization model using linear programming to identify PUR production with minimal environmental impacts. The direct utilization of CO2 for polyols allows for large specific impact reductions of up to 4 kg CO2-eq. and 2 kg oil-eq. per kg CO2 utilized, but the amounts of CO2 that can be utilized are limited to 0.30 kg CO2 per kg PUR. The amount of CO2 utilized can be increased to up to 1.7 kg CO2 per kg PUR by indirect CO2 utilization in the PUR supply chain. Indirect CO2 utilization requires hydrogen (H2). The environmental impacts of H2 production strongly affect the impact of indirect CO2 utilization in PUR. To achieve optimal environmental performance under the current fossil-based H2 generation, PUR production can only utilize much less CO2 than theoretically possible. Thus, utilizing as much CO2 in the PUR supply chain as possible is not always environmentally optimal. Clean H2 production is required to exploit the full CO2 utilization potential for environmental impact reduction in PUR production.

Download Full-text

The diagnosis process of Collet-Sicard syndrome caused by skull base fracture: A case report

Neurología ◽

10.1016/j.nrl.2020.11.004 ◽

2020 ◽

Author(s):

C. Lian ◽

S. Liu ◽

X. Li ◽

Z.-H. Du

Keyword(s):

Case Report ◽

Skull Base ◽

Skull Base Fracture

Download Full-text

795 Trends in Cerebrospinal Fluid Leak Rates Following the Extended Endoscopic Endonasal Approach for Anterior Skull Base Meningioma: A Meta-Analysis Over the Last 20 Years

British Journal of Surgery ◽

10.1093/bjs/znab134.580 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

A H Zamanipoor Najafabadi ◽

D Z Khan ◽

I S Muskens ◽

M L D Broekman ◽

N L Dorward ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Skull Base ◽

Arterial Injury ◽

Gross Total Resection ◽

Csf Leak ◽

Total Resection ◽

Visual Improvement ◽

The Impact ◽

Reconstructive Techniques ◽

Over Time

Abstract Introduction The extended endoscopic approach (EEA) provides direct access for resection of tuberculum sellae (TSM) and olfactory groove meningiomas (OGM) but is associated with cerebrospinal fluid (CSF) leak in up to 25% of patients. To evaluate the impact of improved skull base reconstructive techniques, we assessed published CSF leak percentages in EEA over the last two decades. Method Random-effects meta-analyses were performed for studies published between 2004-2020. Outcomes assessed were CSF leak, gross total resection, visual improvement, intraoperative arterial injury and 30-day mortality. For the main analyses, publications were pragmatically grouped based on publication year in three categories: 2004-2010, 2011-2015, and 2016-2020. Results We included 29 studies describing 540 TSM and 115 OGM patients. CSF leak incidence dropped over time from 22% (95% CI: 6-43%) in studies published between 2004 and 2010, to 16% (95% CI: 11-23%) between 2011 and 2015, and 4% (95% CI: 1-9%) between 2016 and 2020. Outcomes of gross total resection, visual improvement, intraoperative arterial injury, and 30-day mortality remained stable over time Conclusions We report a noticeable decrease in CSF leak over time, which might be attributed to the development of reconstructive techniques (e.g., hadad bassagasteguy flap, and gasket seal), refined multilayer repair protocols, and selected lumbar drain usage.

Download Full-text

Pneumocephalus and CSF leak secondary to skull base fracture by pyrotechnical object: case report

Peruvian Journal of Neurosurgery ◽

10.53668/2021.pjns33175 ◽

2021 ◽

Vol 3 (3) ◽

Author(s):

Marcos Vilca ◽

◽

Carlos Palacios ◽

Sofía Rosas ◽

Ermitaño Bautista ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Intracranial Pressure ◽

Skull Base ◽

Rare Complication ◽

Cerebrospinal Fluid Leak ◽

Standing Position ◽

Csf Leak ◽

Skull Base Fracture ◽

Timely Diagnosis ◽

The Right

Introduction: Pneumocephalus is mainly associated with traumatic injuries, being a rare complication but with high mortality rates; it behaves like a space-occupying lesion and increases intracranial pressure. The symptoms are not specific, but in the event of trauma it is necessary to suspect this entity to carry out a timely diagnosis and treatment, since being the product of the skull base fracture it can cause communication with the outside, and the appearance of cerebrospinal fluid (CSF) leak. Clinical Case: a 38-year-old male patient who suffers trauma from a pyrotechnic explosion near his right ear, when handling a pyrotechnic object (whistle) during the New Year, presenting severe pain, slight bleeding in the right ear, feeling faint and holocranial headache that increased in a standing position; likewise, he presents high-flow aqueous secretion (CSF) from the right ear. Brain and skull base tomography (CT) showed air in the intracranial cavity, fracture of the skull base, and the ossicles of the right middle ear. Conservative management was performed using rest and lumbar drainage, presenting a satisfactory evolution. Conclusion: Pneumocephalus is a frequent and expected complication of trauma with a skull base fracture. Its early and timely diagnosis using skull base CT is essential to define therapeutic measures. Accidents due to the misuse of pyrotechnics continue to be a relevant problem in our country. Knowing and disseminating its consequences can help raise awareness in the population. Keywords: Pneumocephalus, Skull Base, Intracranial Pressure, Cerebrospinal Fluid Leak. (Source: MeSH NLM)

Download Full-text

Assessing downstream flood impacts due to a potential GLOF from Imja Tsho in Nepal

Hydrology and Earth System Sciences ◽

10.5194/hess-19-1401-2015 ◽

2015 ◽

Vol 19 (3) ◽

pp. 1401-1412 ◽

Cited By ~ 20

Author(s):

M. A. Somos-Valenzuela ◽

D. C. McKinney ◽

A. C. Byers ◽

D. R. Rounce ◽

C. Portocarrero ◽

...

Keyword(s):

Global Climate ◽

Glacial Lake ◽

Flood Impacts ◽

Impact Reduction ◽

Outburst Floods ◽

Increase Risk ◽

Flood Impact ◽

Social Environmental ◽

Downstream Communities ◽

The Impact

Abstract. Glacial-dominated areas pose unique challenges to downstream communities in adapting to recent and continuing global climate change, including increased threats of glacial lake outburst floods (GLOFs) that can increase risk due to flooding of downstream communities and cause substantial impacts on regional social, environmental and economic systems. The Imja glacial lake (or Imja Tsho) in Nepal, which has the potential to generate a GLOF, was studied using a two-dimensional debris-flow inundation model in order to evaluate the effectiveness of proposed measures to reduce possible flooding impacts to downstream communities by lowering the lake level. The results indicate that only minor flood impact reduction is achieved in the downstream community of Dingboche with modest (~3 m) lake lowering. Lowering the lake by 10 m shows a significant reduction in inundated area. However, lowering the lake by 20 m almost eliminates all flood impact at Dingboche. Further downstream at Phakding, the impact of the GLOF is significant and similar reductions in inundation are likely as a result of lake lowering.

Download Full-text

Documented Evidence of Depression in Medical and Nursing Case-Notes and Its Implications in Acutely Ill Geriatric Inpatients

International Psychogeriatrics ◽

10.1017/s1041610298005274 ◽

1998 ◽

Vol 10 (2) ◽

pp. 163-172 ◽

Cited By ~ 13

Author(s):

Ajit Shah ◽

Tamal De

Keyword(s):

Geriatric Medicine ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Signs And Symptoms ◽

Screening Procedure ◽

Medically Ill ◽

Brief Assessment ◽

Medical Inpatients ◽

Elderly Inpatients ◽

The Impact

Depression is common among acutely ill elderly medical inpatients. Identification of such depression by the geriatric medicine staff would allow early treatment. The impact of a depression screening procedure on documentation of depressive signs and symptoms in the medical and nursing case-notes was examined. Thirty-five sets of medical and nursing case-notes of medically ill elderly inpatients, for whom data from the Brief Assessment Schedule and the short Geriatric Depression Scale (GDS) were also available, were examined for documentation of signs and symptoms of depression, prescription of antidepressants, and referred to the psychogeriatric service. Depressive signs and symptoms were documented in only a few medical (29%) and nursing (11%) case-notes. Only a small number of depressed patients were prescribed antidepressants (20%) or were referred to the psychogeriatric service (13%). The frequency of documentation of depressive signs and symptoms after the screening procedure with the short GDS was associated with subsequent prescription of antidepressants and referral to the psychogeriatric service. The screening procedure itself may increase the general awareness of depressive signs and symptoms and affect its management. These results require replication.

Download Full-text

MEASURING KNOWLEDGE OF JORDANIAN NURSES WORKING IN CRITICAL CARE UNITS TOWARD STROKE PATIENTS

World Science ◽

10.31435/rsglobal_ws/31102020/7214 ◽

2020 ◽

Author(s):

Eslam Abd Alkreem Allsassmah

Keyword(s):

Critical Care ◽

Negative Relationship ◽

Signs And Symptoms ◽

Public Hospitals ◽

Stroke Management ◽

Stroke Patients ◽

Cross Sectional ◽

Critical Care Units ◽

Jordanian Nurses ◽

The Impact

Background. Stroke is a devastating disease. It is a major cause for the neurological admission to hospitals all over the world. Limited knowledge among the critical care nurses about stroke in general and specifically about the risk factors, signs, and symptoms of stroke usually is a main source of delayed prompt stroke management and non-compliance with follow-up rehabilitation. Therefore, there is a need for a study that examines the impact of these factors in order to promote stroke management and improve nursing care outcomes.Aim. This study aimed at measuring the knowledge of Jordanian nurses working in critical care units toward stroke patients.Methods. This cross-sectional study used the descriptive approach in order to measure the knowledge of the Jordanian nurses working in critical care units regarding stroke patients in the Jordanian hospitals. Data were collected from Jordanian critical care units' nurses from seven hospitals; five private and two public hospitals. Critical care units’ nurses were selected conveniently based on specific inclusion criteria. Eligible participants were required to complete self–reported questionnaires about knowledge in addition to completing demographic questionnaires. The descriptive and inferential statistics were conducted using the SPSS software. Results. A total of (200) Critical care units’ nurses from public and private hospitals participated in the study. The nurses in this study exhibited poor knowledge on the study scales. There were statistically significant differences among nurses according to the type of hospital on the one scales (P< .05). There is a negative relationship between the knowledge and years of nursing practice in ER or ICU (P= .013).Conclusions. The measures of knowledge among the nurses in critical care units in the Jordanian hospitals towards stroke patients seem to be highly poor. Nurses in critical care units seem to have acceptable information, but inadequate to correctly enhance stroke awareness. There is a gap that should be stuffed via planning and implementation of educational and instructional programs focused on hospital nurses as well as community sectors in order to improve the stoke focus and experience and avoid the delay in accessing the medical help which would, in return, improve stroke management and reduce its effect in Jordan.

Download Full-text

A Synoptic Review of Forestry and Forest Products Trade and Production in Africa- The Case of Wood and Non-Wood Forest Products in West Africa

10.20944/preprints202201.0031.v1 ◽

2022 ◽

Author(s):

John Adekunle Adesina ◽

Zhu Jiangang ◽

Tang Xiaolan

Keyword(s):

West Africa ◽

Natural Capital ◽

Natural Habitat ◽

Forest Products ◽

West African ◽

Warning Signs ◽

Low Carbon ◽

Forest Reserves ◽

Impact Reduction ◽

The Impact

According to this study, approximately half of Africa's forests are utilized primarily or partially for the production of wood and non-wood commodities. Aims to evaluate Africa's forestry and forest products, namely Wood Forest Products (WFPs) and Non-wood Forest Products (NWFPs) in the sixteen (16) West African countries. While adhering to the following guidelines: wood extraction and preparation, analyzing wood primarily used as an energy source in Africa, identifying non-wood forest products in Africa, the state of export, trade, and customs procedures in West Africa, and examining the role of forests and forest stakeholders in Africa's low-carbon economy transition. An exploratory literature review of selected wood forest products and non-wood forest products (plants and animals) in West Africa identifying the country, the natural land area with the natural habitat issues of the forest, the species most harvested and traded in the West African sub-region. The study reemphasized some government legislation, policies, and market trade failures and limitations while also stating that trees may help in the low-carbon revolution through interventions aimed at maintaining, improving, and restoring natural capital have demonstrated that high environmental requirements of sustainable forest management (SFM) may be met in both natural and planted forests. The study identified a systematic assessment of the most common forest products (wood and non-wood forest products) considering the available data on the national forest reserves of the selected countries in West Africa. The study also revealed the need for biodiversity conservation of the available forest reserves to help mitigate the impact of global warming targeting the United Nation’s Sustainable Development Goal 13- Climate Action. Which is focused on integrating climate change mitigation, adaptation, impact reduction, and early warning signs into the national policies, improving forest planning and management education, awareness-raising, and institutional capacity within the sub-region.

Download Full-text