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1.
Am Surg ; 80(10): 926-31, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25264631

RESUMO

Early diagnosis remains the cornerstone of management of Fournier's gangrene. As a result of variable progression of disease, identifying early predictors of necrosis becomes a diagnostic challenge. We present a scoring system based on objective admission criteria, which can help distinguish Fournier's gangrene from nonnecrotizing scrotal infections. Ninety-six patients were identified, 38 diagnosed with Fournier's gangrene and 58 diagnosed with scrotal cellulitis or abscess. Statistical analyses comparing admission vital signs, laboratory values, and imaging studies were performed and Classification and Regression Tree analysis was used to construct a scoring system. Admission heart rate greater than 110 beats/minute, serum sodium less than 135 mmol/L, blood urea nitrogen greater than 15 mg/dL, and white blood cell count greater than 15 × 10(3)/µL were significant predictors of Fournier's gangrene. Using a threshold score of two or greater, our model differentiates patients with Fournier's gangrene from those with nonnecrotizing infections with a sensitivity of 84.2 per cent. Only 34.2 per cent of patients with Fournier's gangrene had hard signs of necrotizing infection on admission, which were not observed in patients with nonnecrotizing infections. Objective admission criteria assist in distinguishing Fournier's gangrene from scrotal cellulitis or abscess. In situations in which results of the physical examination are ambiguous, this scoring system can heighten the index of suspicion for Fournier's gangrene and prompt rapid surgical intervention.


Assuntos
Abscesso/diagnóstico , Celulite (Flegmão)/diagnóstico , Técnicas de Apoio para a Decisão , Gangrena de Fournier/diagnóstico , Doenças dos Genitais Masculinos/diagnóstico , Doenças da Vulva/diagnóstico , Adulto , Desbridamento , Árvores de Decisões , Diagnóstico Diferencial , Diagnóstico Precoce , Feminino , Gangrena de Fournier/cirurgia , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estudos Retrospectivos , Sensibilidade e Especificidade
2.
La Paz; 2003. 156 p. ilus.
Tese em Espanhol | LIBOCS, LIBOSP | ID: biblio-1312497

RESUMO

El objetivo general readecuar los controladores de temperatura de los tanques de fermentación de cerveza, de la Empresa C.B.N. Santa Cruz, mediante el empleo de los sistemas de Rockwell Automation, para su PLC Allen Bradley, simulados por el programa de stateflow del Simulink de MAT-LAB. Los objetivos específcos: Reemplazar todos los controladores de temperatura, por un controlador lógico programable PLC, que cumpla las mismas funciones que los controladores. Estimar la utilización del accionamiento de las válvulas mediante el algoritmo PID, para evitar cambios instantáneos de las válvulas solenoidales. Volver el sistema más versátil y compacto, de tal manera que si es necesario realizar alguna variación en el sistema solo se tendrá que modificar el programa. Exponer paso a paso la secuencia de control, y las características del sistema. Facilidad de ingreso a una red de campo.

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