Shock Anafilattico: Primo Approccio in Emergenza
Transcript
Shock Anafilattico: Primo Approccio in Emergenza
!"
0
4
5
6
9
:
#
$
! "" #
$ "
"
%
&"
' ") &&"&
+ * "
") ! , - ( .
) *
/"
"
"
" ! , - ( . " ) " ) "
*
,
"
+ * "
"&
1,
&" ) )
% )) 3 ! %"
)"
"
"
+ * " ,
&"
( , - ( .
)
$ %
"
%
&"
(
, - ( .
) *
(' ("7 )
* *"
'" % ")
))
) "8 ('
* &""!
(' ("7 )
!
)(
,
"
+ * "
"&
1,
&" ('
""
(
(' ")
") 8 " "
* )"
$
)" $ &
(+ ; " "$ )"
* " "&
"))
" %'
+
(
% * < "((" " "%
)
( " "
' (( )"
!
%"#
, - 2
*
/"
"' )
""
* &"" !
(
$ " * " ' ) " (+ ; ( 7* - ' - " " "
" - $ " ( < ))" %"
'"
"( <
' +
9= % * < "))" (' ( &
))1 " (% " * "
) - ))
"& ") < > " *")%
( %"
% (
( * '(
(' ")
"
) " 7
( *(
)" "*(" ' ? $ @*
" "$ )"((
)"
(' ("7 )
) :6A
"
(( ' " "$ )"((
( %
" "$ )"((
"'
)) " (
=85= "( (* == ===
) 9=A @* (
(( ( - $ "
9= % * "))1 (' ( &
"))1"
%
(
( " ( ")" ' (
" "$ )"(( " "))
" ") )"
) ' "
(" "
" '"&
(
' ( " $ @*
+ *
7"%7
% ) %
) < (' " 7 $ " " %") *
")
@*"
( ' ((" ' (*''
+ )
- *
* "( "
" '"
( ( <
%"
" ' "C ' (("
"* " "*% " " ' 7"7 ) .
" "$ )" + < ( %7 " ' -"
+ < )'
"( < (( +"
( ) *
( +
('
" (
" '
> ( " "<
) < % ( " " ") * " '
(' ( &
"&&"<
< .<
("
") " " "
" (+ ; " "$ )"
" "$ )"((
'
6 ==
)) " > * 1 "
&
*"
<"
+ *
( %'
B
"
"
"))
"< "(%"
(- )*''"
"&
% ( "*%
)
*'"&
'
)
'
)
1"
( +
%
" "$ )"((
( - * " "&
(( % " (
"' "%
<
*
%
( ( 7 ) &&" < ( * "))1 (' ( &
" * "))
< ) * ) - ))
" > ") + '
" ( + < ))1 %% " < )" - " ) '"&
"$ )"((
$ * " * " (' ( " %%*
' B "&
" ' ( ( 7 ) .C )" @*")
%" "%
<
%'
•
•
•
* "))
"
2( " " 3
)" ' ( &" "
'
'
2(' $ 3 ' )1"
)" (
( )" ) 7 "&
% "
+%
" '"
7"( $ )
- *
( - .
- ) <
#
))
))*)
$$
< %"(
" ( ( 7 ) &&"&
" "$ )" " > $"- " "))1
((
))1"))
))1 " (% " "- ( " * ") < ' -")
%
*
%* (
)) (' "
) "
"( 8
( ") # )"
'
"&
" "- ( ") ( (" & ( "
( % )" )" ' *&
" ""
( " ' *) "
))
> @* ))" '
( $ ((" " %"( ))*)
" *)
7"( $ ) <
@*") ' ((
*
% %7 " " (' $ ' ) $ "%%
))
+ ' "- ( )" ( % )"&
)) %"( ))*) ((* ")
7"( $ )
)"
* "
% ) )" "
77" "
")%
* "
'
$ ((" "))" % %7 " " ))*)" <
$ %"&
* 2'
3$") * % ) )
"
'
" < " (*" - ) "<
% "
)" (* (( -" "
"&
% %7 " " ' ) $ "%%
< @*
<
( * &"
*)
7 +%
%') (( < )"
" *)"&
)" ) 7 "&
% "
+%
((" "%
* '
)" &" ") ' %
"
)1"
<
*""
-" "7 ) < ) @*") ( - $ " )" $"(
( ( 7 ) &&"&
) ( ( %" %%* " < ' %" + * "
(
" (' ( &
)1"
(' $ ' ((" ( " " * " "&
" "$ )" "
'
< ' ) (" "
) "'
B"
"
* )" (
(
"
' ( ) (
) " < %
-")
< " * " ( ( " &" + $* " " "
C(
) ( (" &
"
' - " )" %'" (" )) '
'") "&
" "$ )" + (
"7 ) ))1* %
'
•
'") "*(
"&
" "$ )"
+
'
(
$" %"
♦ '
)) "< $") ('
< (*)$"%
<
" ) < "%
) ( < "%$
" /<
$* "
"< " (
B"
(( "
" "
$
"C< -"
B ((
)
" < $)* &"< % 7 )) C< " (
) ") < (*) "< ' ) (" "
B ( " C<
- "% B "% "< "
$ ) C
♦
%
B (*) "<
< -"( ' (( "< '" " % C
•
•
•
•
•
•
") %
' ))
$* +
)%
- )
)"
B' ( < $ *
%
" "&
" "$ )"
"))" ' ( &"
) ( ((
' ( "&
8 %"< "
% "
@*
%' -- ("%
<- $
%" <
("
< * -"< " " +
<
) <
") < $"
)<
)" C
( '
< - < > '"
)" %
( % ) "))" "&
" "$ )" " ! ( " %
% "
+%
+
)"&
")) ('
%" $ ( "&
)
+
$$
&" ))" "&
" "$ )" "<
> ( ( * " " * % " (%
+
") * " '
$"(
( ( 7 ) &&"&
'
'
(<
"
0
" )
"*"
" "$ )"
'
•
"&
"
"
'") "*(
"
") > * $ % %
((
* "%
"&
" *)"
"%
♦ % &&
•
( (" &
"(
+ ")
♦ "('
•
"*(
'"
"&
%
♦
♦
♦
♦
♦
"
"
+
'
) $$
))*)"
)
< '' "
) % "7 ) (%
))1"
+ )
" "$ )"
))1* % (
< *" <
%
"&
+ 3
" "$ )"
( *
+ D
"
"
"" +
"<
+
♦ $
•
" "$ )"
(*) $"
% " 2 "&
)* < ($ & $ (
"
")
"
"
"&
-"( *)
%")"
<
%"
"$ (%
%') %
%"
" B $
%" " @* (
"($*( ") B'"
&&"
"(
))1
)" %
7
)
'"&
C
$
"* '( $$ *" (* '"&
* ' (+ ; " "$ )"
*% "
) ("
(
%" ((* ") $$*( < ' -")
%
"%7
( & ") < ) ") &&" " ) - ))
' )% <
)) - "
(*'
B )*( )" )"
)1 ' )
C< ))" *
-(
(')"
) - )) ' )% " ' -") ) (
%" ' )% " < ))" %"
'"
"(
"
"< ' ?
%
"(( " "
$ ( %" ' )% " " * <
&"
")- )
' ( (
( *
"((
) "%
(
")- )"
% "
%
%
%
+%
"
"
)7 "
"))
))*)
$$
(
" "$ )"(( ' ((
((
)"(( $ "
' %"
(
"
4
% "
' %" (
)"( "
"%
")) %"( ))*)
" 7"( $ ) %
(
" (
)"( " ")) ")
))*)
- )
"))" ( " "$ )" "< @*")
' "(
) ( $)
% "
' %" (
< ")
- ) "< )"(( $ "
% ' $ %"
(
(
( " "$ )" "
•
'
((
♦
♦
♦
♦
♦
♦
♦
♦
♦
♦
•
(
"))1" -
))1"
B%
( "% "
$"
+ % "
'
$"
+ % "
'
;"))
"
'" "
"
( "
(
"
'
& %" +
'
) "
' (( "( < (*' ((
&&"
'
♦ ) *
♦ ' ( " )"
♦
♦
"7 )
)
"
(
*
(
))"
' %" C
$)
" $ )"(( B
$ ) ))1" "$ )"(( B
8 C
8 C
(%* "(
)1"
0<
0<
B%
0
"
(
%7 (("
" C
0
))1 0
1"&
'"
" 2 *%*)" -"3
))1" "$ )"(( ' - "< %
(
•
•
•
)
"
% "
* $)< )
(
" "< " ) - )) ( ( % < " %
<) ( *
$ "% ")
( * &
"
+%
-"( )" "&
"
)"
"*%
))" ' % "7 ) . "' ))"
7
( &
(
(+ ; " "$ )"
< )" -"( )" "&
"
)"
> (' ("7 )
) (
%
"%
( ( & -"( )" ' $ + %" " "%
< ' (E< ' * ( ( 7 )
*&
)
- (
))"
"" " " "
- ) ( @* ( "&
%" " " ) - ))
) %"
) (')"
) '"&
' ( "* "
&
(' " " ' - ) % " )" -"<
)" " "))" (' ' &
"
*
+ ( ") &&" " ) - )) -"( )" ( ( %
@*")
"
( * &" ))"
-"( )" "&
$$*(" < '"
)" %
< "))" "*% " " ' % "7 ) . "' ))"
+ ' *
(' *" '
"
')"(%"
)
( & < $")
"%
)"
%'" ("
%
"&
< '
(
"
("< " + " "<
*&
)) ' ((
" " +
%' %
*&
))"
"" " " "
" ( " "$ )" "< ( ''* " "%
< '*F ((
(' ("7 )
@* ( '"&
))" %'" ("
% "
' ((
)" "< '"
)" %
'"&
' ((
"
'" "
( + % "# (
( " ( ")" "))"
"*" '(
(
&"< " + "
( $" ") <
(
%
" + " *
% "
"( ' ? ( - < %'"
%" ' )% " " * <
""
( + $ ( '" )
+ ") +
(
)1 @*" "%
@*")
%" ' )% " " * 2) ( ") 3< " "*% " " ' % "7 ) .
%
-"( )" " ) - ))
))" 7"
" ")- ) 8 "' ))" <
%
*% " < "
( %' < ")
5
% "
(
%
"%
-")
%")
7"((
))" ' ((
* "%
"' ))" ' )% " B G C
"))1" ") (
) $)*
+
" ) ")- ) ' )% " < ) @*")
' ( "
"&
")7*% " '" "%
' ((
" ) * " ") + "
%")
-") ')"(%"
) (
) @*"
" " % '" )
$ ( %" ' )% " " * <
' ('" (
(
")- )"
"((
) "%
(
")- )" < '*F ((
$ ( '" )
"%
(' "
)" "%%" "
(( . " '"
) '"&
$$ *"
(' "&
$ &" < (
"' - "
)"
* " ))" '"
")- )" <
)1 ( *&
( " " )) - "
(*'
' - ""
"))1 %" ))" )
(+ ; " "$ )"
'*F "- )* < '"
)" %
@*"
)1" (( "))1 " (%
) "
( " " ( ") && ' - "
- (" B- )
%
< $" %" C< ( &" ((
'
*
"))" %'" (" ") * " %" $ ( "&
* " "< "(
"< (' " "
) @*"
)
'*F ('
"' "%
") " "%
"' *
''* <
"(
""
&&"
" %"
"- .< '*F * " *
-"))
%' ") -" "7 ) < + ( ))" "
- (
" - (
) @*"
)
) '"&
< ' * " (' ( " ") " "%
$"- - ) < '*F ' ( " ( <
" ")
'
'" "%
"- .< % "%
"9! 0
( " &" "))1 ' (
& ")
")
%'" ("
))"
"&
" "$ )" "<
% " " " "$ )"((
" " "<
( * "))"
% "&
)) %"( ))*) <
7"( $ )
) *
' )% $ * ) "
)) "
('
"))" (
*&
))1"
<
( * &" ))" @*") ( - $ " * " * -"
""
)"( ( ( %
% "
-"( " -
" ( " "$ )" "< ))" %"
2 "*(" ( " " 3< + )1" "% (
•
•
•
•
'"
%
"( < ( %" $ ( "
&" - "((" "' "%
"((* &
* $" %" B' - " ") < (
* " "<
( %% ( "&
* % &&
"( " $
"
(
"((* &
7 2( ('
3B (
(" C
% ( D '* * "
(
B ( %
C
(
%
))"
( " "$ )" " ' ((
%' " "%
"( *
"
( ( %"
(("
'
'")
$ * "&
) + " '
& ") %%
'
"%
( *
" *" "%
"$$
" ") %
%' % ((
•
•
•
•
•
* "
("
C
(
)"&
"
" *"
)) - "
))
"- (
-
'
'
)
%
%
- "< +
&"< (
-
((
(*'
"*
#
"'" . '" )" #
($" "#
( ("&
<'
(( -"%
"'" .
(( #
%' % ((
" *"
(' " " ( - "
%'"
"
<
$
2
(
(
" 3 "))"
%
)
)"#
"
"
(*$$
&"
6
•
•
•
•
7
('"(% " * #
(' "
("#
" + ' " %" " " B$ @* &" (' " " H 5= " D% C#
" ) ' )% "
$$*( B - *") ' ( &"
%" ' )% " " *
(
"
"<
( *
" "*% " " ' % "7 ) . %
) - ))
))" 7"
" ")- ) 8 "' ))" C#
("
" *"
•
•
•
•
•
•
•
(+ ;
( 7* -
%" $ ( "&
•
•
•
%"
'*
"
%" $ ( "&
•
•
•
%" $
•
•
*")
% "
(
%
"
(*$$
&" "
" "
'
(
"
(" ( - "<
-")
( ( ) " I J= %%
I 5= %%
"
) - )) 7"(")
"*%
))" ' ((
"
("
$$
& ") B'
*&
))"
"( ) "
( *
"))" -"( )" "&
%"(( -"C
" + " " B' (( 7 ) < ( " '* " "%
< ) (
7 " " "C
* ") " (* " "<
'")) "
%' % ((
) ( (
B(
' $)
(
)
'
(( -"%
'
" - " ( " K $*(
K ( *' < %"C
" ) ' )% " 7 )" ") < @*") ' ((
((
7"(") < %
87"(") ''*
$$*(
*
"%' "*( *) "
B F ( - $ " @*"
("' (
%" ' )% " " *
"
<
( *
"))" ' *((
2(
"3 " ) - ))
" "
% " (%
"&
' *) "
% ) ')
% "
+%
))1" "$ )"(( <
"
' *
% "
' ((
< (
%
" + " *
D " + !
7 " " % 2% "
( 3C#
' ( &"
& B 4C @*" B 5C
" " <
- *")
%'" (" ( $$
* -"
(
&" B
"
" %"
( *
"
%' -- (
%")$* & "%
-")- )"
% "
" ( + %" " *"
%*( ) '"' ))" #
' (( 7 ) (
< @* ( "( < )" %'" ("
(*$$
&" % ") " " * "C
") @*" " '
& ")
"'
("
%'" ("
" %'" " (
( *
(
%" )
' *) "
-
2) ( ") 3<
-"( )" "
(
%%
'
)
- " ' ((
( - "'' ( &
" ) -"
( *
))*( "
@*") <
))" ( " "$ )" "
<
% (* " -" "7 ) <
$ @*
' )
' ( "&
)
"<
$ @*
< "* * "
2)
3
*"
$$*(
") &&"
%"
"(
"*( "< - %
) " % ")
" "
( "&
* )
'
%' % ((
(
")
"%' $ %
+
)( (
9
) ("%
((
•
•
•
•
•
•
•
•
•
•
*
(
<
<
(
8 $$
' --
& ")
" "(( * "
%
"
"
-
((
(
"
* "''
% )"
"
<
C
(
'"
) ( *
))"
(
'" )
" *
"( C
(*'
( &" ") * " '
"
(
' ("
)
"
"$
%
-"( ))" ' ((
"
%
(" * %
'*)( (( %
-")* "&
% "(" ") "
"
&&"&
- ( ")
"
@*")* @* ") " " * "
-"( -" ")
+ ")
" "
%"
" B $
))1 7
( (( % "
- ") 7"
+
)) - "
(("
"
(+ ;
"&
"(%" 7
(
%
"
%"(
$ &
1
((
(
"
%
"&
) -"
) - ))
( "% " (
"
' )* "%
'" "%
% " *)" - B
*&
) %') %
"
( % "7 ) "
•
•
•
•
•
•
•
)"7 "
" -")* "&
"
%'
*
("
) '"&
)" %
("
"$$ " "
(+ ; " "$ )"
* " )" (@*" "
+
(
"
( <
((" "%
) * "%7
:
' " - ) '
% " &"< >
•
( %%
•
""
*
(
")
-")* "&
K "&
(' ("7 ) "(( * " < ( @* &"< ) ( *
( "
((
)" ' -
<
.
%"( + " $"
)) - "
•
7)
'
"
*"
%%
% " '*F ((
*7"&
" "%
)1*)
L*") " ) ( % ) "
%
< $" %"
(' ( &
+ % "C
(') "
(*''
@*"(
D%
%" )) )"77 "< ))" ) *"< ))1*
( % )
+
- '
*'"
"- (
%' % ((
)) - "
' ( &"
%"< (
(
%
(' "
< ("
(+ ;
)"%" <
*7"&
" + ")
) '"&
<
% " "#
)"
)" '
((
(*'
)" ' ( &"
* -( ( "
'")" % )) "'' ( " *
"* "'
& ") "' "
) '"&
#
") < " 6 )
( "
'
( $$ "%
< ( ( ((
' -%% " "%
"))"
( *
%
< "))" (*" - )"&
((" " @*") " )"
" + ") #
(' ( &
)" D
)
")) "
(*'
"- .
))1"
%" %'
( "
"))1"
( " ) ") &&" " * " ( % . B" ( '*
)
( %% ( "
'
-" (
*" "
"%*( )" <
'
"' "%
%
( *
))*( "
"'') " * )"
% ("
- (
'' (
"))1 ( % .
((" "< ' (( %")%
") (
(' ( &
"))1"
< ") $
( " )" )"
)"&
) $" " - ("#
%* '
"%
) )"
B"
(
% *
= % C<
%"
(" %
)1"
' (&
)- #
( "
"* )" )1 - *") '*
)
* ( &" (' % ) < '
- " * " *)
) 7 "&
)- ) #
'*) )" '"
" @*")( "( ( ( " &"< * ) &&"
' $
& ")%
" @*"
("'
* #
"'') " ) ")%
+"
'
6% *
4= % *
)"
"&
>(
( ('
%') "%
*
•
%%
( "
"
" " "))" ( %%
%% " "%
*7 ) ( ( %"
( "&
)1 $*(
$*(
* $" %" ' - "
) $" %"
- ("<
( ( *
") "
'
" "%
" " ( * *')
" (( -"( )" - ( ' $
" " *) 5 ! 9 #
)" ( %% ( "&
"
") " - ((
%' " " " ' -- %
.
" #
)1"
") " > ) $" %"
' %" ( ) " ) " "%
)) "&
" "$ )" + #
)" (*" '
"&
")$"
7 "8"
" " "
&&" )1"
%"< )"
7
( &
< )" -"( )" "&
) ")
$$
% "
))1" "$ )"((
(("<
) < 7 ( )1*)
) 7 "&
% "
" %"(
" 7"( $ ) #
)1"
)" - "
") " '*F ((
(" ' - "
( %% ( "&
( %% ( " " '
-" (
* " "<
" + ") #
'
"))" "- . ))" "&
" "$ )"
"%*( )" <
"
-" (
*" "
"%*( )"
"'' ( " ) ( %% ( "&
%"
%
"'' ' " < '"
)" %
)" - "
"%*( )" <
"(
) %"
& ")
)) - "
< ) - 7
('"(%
"&
" "$ )" + * "
( )"
( %% ( " =<4 ! =<6 %
* " ( )*&
=== B=<4 ! =<6 %)C (
%
= ! 0= % *
)" (
))" (' ( &
"
" '*F ((
+ " "%
$ " " B"
( )" (
))1
&
))1"))
C * " '"
))" (
"
") " B=<
! =<0 % C '*F ((
""
"%
)
%% ( "&
' -"
- (" "'' ( " )" - " %"
%
"'' ' " "
"(
%" )"
<7
('"(% ( - < ( "
)"%"
(+ ;
"% ' $ 7 )
)*
%) * " ( )*&
"
") "
= ===
= %)
( )*&
$( )
" B=< %
"
") "C ( %% ( "
7 ) )
6% *
" ( '*F ((
' *"* "
* - )
=% * <(
(( .
) '"&
" &" <
%")" " "
-"( )"
"<
"7
% )) <
%")"
<
'
(
"&
)" ' (( 7 ) .
*("
& ")%
% . ))" ( ( ' " " %" " "
L*"
( " '"
)" %
$$ )
( * * " (( -"( )" - (
'
- " 2 - & ") 3 B ( "
*7 ")
))1"-"%7 "
< - "
* *)"
(
"C<
' -" " ( %% ( " )1"
") " " "- ( )"
- " $ % ") ''* " "- ( ) ) ') (( - ( (*7) *")
♦
%%
( "
%% ( "&
' " ( )
)" "' " (
&" ( " .
( %% ( " " % "
%(
* " ( )*&
0 06 A )* "
)1"
") "< '"
)" %
@*"
( ( ('
' (
)1 %" )"
< '*F ((
* )%
)" " % " 7*) &&" "
" ( ) =<6 %)
4 6 %) ( )*&
$( )
"
%% ( "&
' -"
" + ")
" (
" @*"
("
( " ' (( 7 )
( * * -")
" (( -"( )" - ( ' $
)
&
)
+
) '"&
"77 "
(' (
%
(
($"
"))" ( %% ( "&
"%*( )"
"
") "< ) $" %" '*F ((
( %% ( "
" + '
-"
" + ")
" "- ( )" % %7 " "
"< "*"
"
'' " ) ("
%")%
' -( '
)" - " L*"
<
"( ' ? "- < ( " $")) *
" ( %% ( "&
'
-" ( " ( " ' (( 7 ) ( %% ( " )" ' - "
" + ")
( ("
( *
"- )"
"%
( %% ( " " ' - " " (
"< )"
( %% ( "&
"
") " - ((
*" " ' - " %
) @*
J
) '"&
("
(+ ; " "$ )"
> ( %'
( * &" ))1 %'
( "-"(
") &&"
)
( &#
< ' " < ( %% ( " "' "%
")%
4= % * < (
(( .
•
" "
)7
('"(% (
' ((
((
%" " "%
$)*
")
)
(
' - ) % <
-"( )"
( "))
0=8
(( .
( %%
( "
")7*
) 0<6 ! 6 % ' " ( )
0= % * < (
(( .#
"% $ )) " 9 % D
D - %
(
"
B( ) '"&
"((*%
.
$ ))
C 0= ! 4= % *
1 '' *
"))" ( %% ( "&
$ ))
@*"
-")
' ((
("
( " " *" "%
( "7 ) &&"
1"% $ )) "< ' )" (
"
< '*F ((
* )%
( %% ( " "
$*(
*"< ") ("
=<0 ! =<J % D D "
('
♦
"
%%
) ( *
( "
>
'
"
(
")
") "
'
) '"&
" %
"
)
"$
"$
* < "))" ( %% ( "&
"
") "
$*(
*" % B %) * " ( )*&
===
= %) * " ( )*&
= ===C )*
6== %)
( )*&
$( )
"< $*( "))" - )
.
=<6 ! 0 =
%)D% B
('
" ! 5 µ D% C
♦
%%
''
"
.
("
*
"
'
<
(
( "%
"
"(( &"
('
) $
"% " = ! 0= %
( "%
-"( )"
)"
"&
"
0 "
"< 6= %
( "%
0
"
))"
*&
% " "))" ( % )"&
•
" "
)1 -
*") '
1'
+
(
)1 %'
(
$ " " "<
*
$ +
"&
9
# )1"&
"( " )1"*%
)) $ 7
))*)" %*(
< '*F ((
( %% ( " "
" "
("
$
") &&"
))" ' % "7 ) .
)" ) ( 7
+ ")
9
1"&
" "
("
$
"( " )M"*%
))" $ @* &" " " "< ) " % <
" )"
)" -"( ( &
" "
") 0 " ) - )) % "
$" " "
("
( *
'"% "< ''*
"
") "< 0 ! 0 µ D %
)" ( %%
$" %"
( "&
"
") "< '*F
-
=
1'
(
2"
(( -"3
(
' ( "%
•
%%
("
$ " " "<
(
"
") " $)* <
"
%
"%
(+ ; " "$ )"
< "))" ( %% ( "&
+
((" "%
+ ) '"&
("
-"( -
(
(
(
$" %"
"'' ' "
"&
" "$ )" "<
'"
)" %
' ( &"
%" )) - "
<7
('"(% ( - < ))"((
"
-"( )"
'
(
"
("
'"
)" %
* )
) ) % " )" * " " D )1
( .
))
"&
' )* "
") " " +
)' 2)1" "$ )"((
" " "3< " +
- ? ))"
)
"'" .
7 )" (
(
( "% "
+E
"*% " )" (' ( - .
((* ") " $" %"
7 " "
( ( %% ( "
("
)"
%' ( -"
( %% ( "&
)1 %'
("
" *" < )" ( %% ( "&
(
(
(+ ; " "$ )"
+" % ( " < %
*% "
(* <
((
%* @*
" ! ")%
) 0=A
"( 8
%'
< " ( " &"
8 0
" "))1"''"
( )*&
)
(
%" )
& ") <
)"
%'" ("
))" 2(
"
" "3< (( " )"
' ( "&
) @*"
)
2% "
( ' )" - "3 ) '"&
% "
2" "$ )"(( " " "3
((
((
")
*"
( %%
( "
% )'
( ) < 06 % -< "
''*
( < 06= % -< " '
•
%%
( "
'
9 !
98
(
<(
(( .<
(( .
)* "
" ( %% ( "&
)* "
'*F ((
'"
)" %
"((*%"
7 "7) " < ' +E ) )* "
< ' *
"&
" ))*)"
) <
% " (%
"))" - "
"
7 "8 < ( % )" )" $* &
+
'"< 2( "-") "
3 $* & ")%
) 7 "7)
* )
'"&
)1"*%
"&
'
" " " ("
+
))
'"
N" " *
- ((
%)D%
%
( %%
)* "
( "" '
"
)
- " - ")
( )*&
("
)* (" " ") 6A )1 $*(
68 6 µ D% <
>
6 ! 6
//
•
•
•
•
•
•
/ )) "*
"'+O)"P ( "
*%
; ((8 "; ) " / '
*
+ "'O 0==4 !
"*
( 0==4< '"
8 4
/ Q
"'+O)"P (8
G" )) P$
P7 ; $
! P$
, - ( O
(( 0==4< '"
0448 050
"*'
"'+O)"P ( "
"'+O)"
+ ; ! R " ))
") "
!
(7O 0== < '" 6 4 ! 609
* )) %"
")
)) O< O' ( ( - O "
"'+O)"P ( !
( 1( %
O
!
(7O 0==0< '"
9 J ! 945
" " "
+ ; "$ )"
8
"
<
/")&" ))
" "
)) %
&
+ *
+
"' "
( -" !
%" 0==4< '"
06J8 0:9
, )
")
"'+O)"P ( ! Q "
'' 1(
(- "
8 ''
0==4<
'" 0 4 ! 0 05
0