Sample records for quadril minimamente invasiva

  1. MINIMALLY INVASIVE SURGERY FOR GASTRIC CANCER: TIME TO CHANGE THE PARADIGM.

    PubMed

    Barchi, Leandro Cardoso; Jacob, Carlos Eduardos; Bresciani, Cláudio José Caldas; Yagi, Osmar Kenji; Mucerino, Donato Roberto; Lopasso, Fábio Pinatel; Mester, Marcelo; Ribeiro-Júnior, Ulysses; Dias, André Roncon; Ramos, Marcus Fernando Kodama Pertille; Cecconello, Ivan; Zilberstein, Bruno

    2016-01-01

    Minimally invasive surgery widely used to treat benign disorders of the digestive system, has become the focus of intense study in recent years in the field of surgical oncology. Since then, the experience with this kind of approach has grown, aiming to provide the same oncological outcomes and survival to conventional surgery. Regarding gastric cancer, surgery is still considered the only curative treatment, considering the extent of resection and lymphadenectomy performed. Conventional surgery remains the main modality performed worldwide. Notwithstanding, the role of the minimally invasive access is yet to be clarified. To evaluate and summarize the current status of minimally invasive resection of gastric cancer. A literature review was performed using Medline/PubMed, Cochrane Library and SciELO with the following headings: gastric cancer, minimally invasive surgery, robotic gastrectomy, laparoscopic gastrectomy, stomach cancer. The language used for the research was English. 28 articles were considered, including randomized controlled trials, meta-analyzes, prospective and retrospective cohort studies. Minimally invasive gastrectomy may be considered as a technical option in the treatment of early gastric cancer. As for advanced cancer, recent studies have demonstrated the safety and feasibility of the laparoscopic approach. Robotic gastrectomy will probably improve outcomes obtained with laparoscopy. However, high cost is still a barrier to its use on a large scale. A cirurgia minimamente invasiva amplamente usada para tratar doenças benignas do aparelho digestivo, tornou-se o foco de intenso estudo nos últimos anos no campo da oncologia cirúrgica. Desde então, a experiência com este tipo de abordagem tem crescido, com o objetivo de fornecer os mesmos resultados oncológicos e sobrevivência à cirurgia convencional. Em relação ao câncer gástrico, o tratamento cirúrgico ainda é considerado o único tratamento curativo, considerando a extensão da

  2. Petrogenesis of metaultramafic rocks from the Quadrilátero Ferrífero and adjacent terrains, Minas Gerais, Brazil: Two events of ultramafic magmatism?

    NASA Astrophysics Data System (ADS)

    da Fonseca, Gabriela Magalhães; Jordt-Evangelista, Hanna; Queiroga, Gláucia Nascimento

    2018-03-01

    In the worldwide known Quadrilátero Ferrífero and the adjacent terrains, southeastern Brazil, many serpentinite and soapstone quarries, and some rare bodies of metaultramafic rocks that partially preserve minerals or textures from the original igneous protolith can be found. It is not known if the protoliths and the ages of the metaultramafic rocks found in the Quadrilátero Ferrífero (and its oriental basement) and Mineiro Belt regions are the same or if they represent distinct magmatic episodes. The petrogenetic investigation, specially concerning the REE contents, aimed to gather informations about the type of magmatism and the mantle source in order to compare the metaultramafic rocks of both regions. The interpretation of the data concerning petrography, mineral chemistry and geochemistry shows that the metaultramafic rocks are similar to komatiitic peridotites, with MgO contents > 22 wt % and TiO2 < 0.9 wt %. The plot of the REE for the lithotypes found in the Quadrilátero Ferrífero shows decrease in LREE possibly reflecting the depletion of the mantle source. On the other hand the samples from the Mineiro Belt are enriched in LREE suggesting a mantle source enriched in these elements. This enrichment may have been caused by mantle metassomatism that occurred during accretion of the Paleoproterozoic magmatic arc that generated the Mineiro belt. In this paper, we therefore suggest two periods of ultramafic magmatism. The first one found in the Archean basement of the Quadrilátero Ferrífero, with a depleted mantle source. The second occurred in the Paleoproterozoic basement of the Mineiro belt, having a metassomatized mantle as source.

  3. Fístula arteriovenosa após termoablação com laser endovenoso 1470 nm: relato de caso

    PubMed Central

    de Araujo, Walter Junior Boim; Guimarães, Adriano Carvalho; Moreira, Ricardo Herkenhoff

    2016-01-01

    Resumo O tratamento tradicional da insuficiência da veia safena magna (VSM) inclui a ligadura alta na junção safeno-femoral combinada com a fleboextração. No entanto, a morbidade associada à insatisfação do paciente com esse tratamento tem conduzido ao desenvolvimento de técnicas alternativas, e a termoablação com laser endovenoso (EVLT) tornou-se uma alternativa minimamente invasiva à cirurgia. A formação de fístula arteriovenosa (FAV) durante o EVLT é extremamente rara. Neste estudo, relatamos um caso de identificação ecográfica de FAV entre um segmento da veia safena acessória lateral e a artéria femoral superficial. Optou-se inicialmente pela realização de duas tentativas de compressão com transdutor linear, sem sucesso, e alternativamente o procedimento cirúrgico foi realizado sem intercorrência e com resolução da FAV. Esse relato de caso evidencia a importância do seguimento de vigilância ecográfica após o EVLT tanto para o controle da efetividade do método como para o diagnóstico e tratamento precoce de suas complicações. PMID:29930599

  4. Fusión intersomática lumbar extraforaminal mínimamente invasiva

    PubMed Central

    Landriel, Federico; Hem, Santiago; Rasmussen, Jorge; Vecchi, Eduardo; Yampolsky, Claudio

    2018-01-01

    Resumen Objetivo: El objetivo del presente trabajo es mostrar la indicación, técnica quirúrgica, resultados y complicaciones de la vía de abordaje extraforaminal para fusión intersomática (ELIF) mínimamente invasiva. Introducción: El ELIF se caracteriza por la remoción del proceso articular superior (PAS) y el acceso a la raíz intracanalicular y disco a través del triángulo de seguridad de Kambin. Material y Métodos: Estudio retrospectivo de 40 pacientes operados consecutivamente entre el 2013 y 2015. Se incluyeron pacientes con lumbalgia o dolor radicular por enfermedad degenerativa discal, espondilolistesis grado 1 y 2, hernia discal recurrente y estenosis receso-foraminales. Se utilizó la escala visual analógica, el índice de Oswestry, la escala de Weiner y los criterios de MacNab modificados para evaluar el dolor, resultados clínico-funcionales y satisfacción del paciente al año de la cirugía. Las complicaciones fueron documentadas de acuerdo a su gravedad en 4 grados. Resultados: 25 mujeres/15 hombres con una edad promedio de 57 años. El 47.5% fueron tratados por espondilolistesis, el 25% por estenosis receso-foraminal. Se colocaron 54 cajas intersomáticas y 188 tornillos pediculares percutáneos. La duración quirúrgica promedio fue 245 (±25.4) minutos. El tiempo de internación promedio fue 3.5 (±0.49) días. Presentamos 9 complicaciones Grado 1 y una complicación Grado 2. La escala de ODI preoperatoria promedio fue de 51.9 ± 4.96, al año de 12.2 ± 3.19, evidenciando una mejoría significativa (P < 0.0001). La EVA promedio para lumbalgia mejoró de 8.81 ± 0.62 a 2.12 ± 0.89 (P < 0.0001). El 77.5% presentó fusión en los grados 1 y 2 de Bridwel al año del procedimiento quirúrgico. Conclusión: El ELIF es una alternativa de tratamiento quirúrgico segura y eficaz. Se pueden lograr resultados clínicos satisfactorios comparables con las técnicas tradicionales con la resección facetaria limitada al proceso articular superior

  5. The shear zone-related gold mineralization at the Turmalina deposit, Quadrilátero Ferrífero, Brazil: structural evolution and the two stages of mineralization

    NASA Astrophysics Data System (ADS)

    Fabricio-Silva, Wendell; Rosière, Carlos Alberto; Bühn, Bernhard

    2018-05-01

    Turmalina is an important orogenic gold deposit located in the NW region of the Quadrilátero Ferrífero. The deposit is hosted in an Archean greenstone belt composed of ortho-amphibolites and pelites with interleaved tuffs metamorphosed under amphibolite facies conditions and intruded by a granite stock. The orebodies are controlled by WNW-ESE-trending shear zones, associated with hydrothermal alteration. Three deformation events are recognized in the Turmalina gold deposit: D1 and D2 are the result of a progressive Archean deformation under ductile conditions between 2749 ± 7 and 2664 ± 35 Ma; D3 is characterized by a transpressional event under ductile-brittle conditions with the age still unclear. The three generations of garnet observed show that Grt1 blastesis is pre- to syn-D1 and Grt2 growth during the late to post-deformation stages of the D2 event. The initial temperature (Grt1 core) is around 548-600 °C, whereas during late D2, the temperatures reached 633 °C (metamorphic peak-Grt2 rim), likely as a result of granite intrusion. The Grt3 resulted from re-equilibration under retrograde conditions. Two gold-bearing sulfide stages were identified: pyrrhotite-arsenopyrite ± löllingite ± chalcopyrite ± gold stage I precipitated below a metamorphic peak temperature of 598 ± 19 °C associated with S1 foliation (D1), and pyrrhotite-pyrite-arsenopyrite ± chalcopyrite ± gold stage II is located commonly along V3 quartz-carbonate veinlets with a temperature range between 442 ± 9 and 510 ± 30 °C. We suggest that the granite intrusion imposed an additional thermal effect that promoted further dehydration of country rocks. The Au derived mainly from a metamorphic fluid source but potentially mixed with magmatic fluids from the granite.

  6. Banded Iron Formations of the Cauê Formation, Quadrilátero Ferrífero Minas Gerais, Brazil: A novel pre-GOE record of biospheric evolution

    NASA Astrophysics Data System (ADS)

    Lee, B. K.; Tsikos, H.; Oliveira, E. P.; Lyons, T.

    2016-12-01

    The rise of atmospheric oxygen (O2) is a milestone in the history of life on Earth. Banded Iron Formations (BIFs) record major episodes of chemical sedimentation, while providing multiple lines of evidence for the environmental conditions present at the time of their deposition during the Archean and Paleoproterozoic. They are direct products of seawater redox, specifically of the balance between iron, sulfide, and oxygen availability. At the same, they are recorders of the broader isotopic and elemental compositions of seawater, which reflect diverse processes in the ocean and on land. In addition to their relevance to the history of environmental oxygen levels, BIFs also have enormous economic importance. BIFs from the Cauê Formation of the Minas Supergroup in the Quadrilátero Ferrífero (QF) ("Iron Quadrangle") are located on the southern edge of the São Francisco Craton. The Cauê Formation, a superior-type iron formation, is likely coeval with iron formations of the Transvaal and Hamersley basins. The geochemical properties of BIFs from the QF are poorly known, although previous studies suggest mild oxygenation of seawater at the depositional onset of the Cauê formation around 200 million years before the Great Oxidation Event (GOE) based on negative anomalies of Ce and Th/U ratios. The ultimate goal of this study is to evaluate environmental conditions proximal to the Archean-Paleoproterozoic boundary, but particularly prior to the GOE, as recorded in the Cauê Formation. Our drill core samples are unweathered and among the least altered materials available from the Itabira Group. These 197 samples cover the entire sequence of the Cauê Formation (dated at 2.65 Ga) as well as the overlying Gandarela Formation (2.4 Ga). We will look at the redox cycling of iron (Fe) and manganese (Mn) from these samples by analyzing variations on Fe and Mn concentrations as well as Fe isotope signatures that will potentially fingerprint the pathways of precipitation of

  7. The Tonalite-Trondhjemite-Granodiorite (TTG) to Calc-alkaline Granodiorite-Granite Transition: Evolution of the Archaean Basement of the Quadrilátero Ferrífero Province (Southeast Brazil)

    NASA Astrophysics Data System (ADS)

    Farina, F.; Albert, C.; Lana, C.; Stevens, G.

    2014-12-01

    The Bação, Bonfim and Belo Horizonte domes are the largest domes in the Archaean Southern São Francisco craton (Quadrilátero Ferrífero, Brazil). These domes are mainly formed by fine-grained banded gneisses typically intruded by leucogranitic veins and by weakly foliated granites, cropping out as large batholiths and small scale-domains closely associated to the gneisses. Granites and gneisses have high silica content (70-76 wt%), K2O ranging from 2wt% to 6wt%, Sr from 600 to 40 ppm and La/Yb from 150 to 5. Based on their K2O/Na2O ratios, these rocks are subdivided in three groups: sodic (K2O/Na2O≤0.7), transitional (0.7

  8. The geology of the Morro Velho gold deposit in the Archean Rio das Velhas greenstone belt, Quadrilátero Ferrífero, Brazil

    USGS Publications Warehouse

    Vial, Diogenes Scipioni; DeWitt, Ed; Lobato, Lydia Maria; Thorman, Charles H.

    2007-01-01

    The Morro Velho gold deposit, Quadrilátero Ferrífero region, Minas Gerais, Brazil, is hosted by rocks at the base of the Archean Rio das Velhas greenstone belt. The deposit occurs within a thick carbonaceous phyllite package, containing intercalations of felsic and intermediate volcaniclastic rocks and dolomites. Considering the temporal and spatial association of the deposit with the Rio das Velhas orogeny, and location in close proximity to a major NNW-trending fault zone, it can be classified as an orogenic gold deposit. Hydrothermal activity was characterized by intense enrichment in alteration zones of carbonates, sulfides, chlorite, white mica±biotite, albite and quartz, as described in other Archean lode-type gold ores. Two types of ore occur in the deposit: dark gray quartz veins and sulfide-rich gold orebodies. The sulfide-rich orebodies range from disseminated concentrations of sulfide minerals to massive sulfide bodies. The sulfide assemblage comprises (by volume), on average, 74% pyrrhotite, 17% arsenopyrite, 8% pyrite and 1% chalcopyrite. The orebodies have a long axis parallel to the local stretching lineation, with continuity down the plunge of fold axis for at least 4.8 km. The group of rocks hosting the Morro Velho gold mineralization is locally referred to as lapa seca. These were isoclinally folded and metamorphosed prior to gold mineralization. The lapa seca and the orebodies it hosts are distributed in five main tight folds related to F1 (the best examples are the X, Main and South orebodies, in level 25), which are disrupted by NE- to E-striking shear zones. Textural features indicate that the sulfide mineralization postdated regional peak metamorphism, and that the massive sulfide ore has subsequently been neither metamorphosed nor deformed. Lead isotope ratios indicate a model age of 2.82 ± 0.05 Ga for both sulfide and gold mineralization. The lapa seca are interpreted as the results of a pre-gold alteration process and may be

  9. Assessment of the usability of a digital learning technology prototype for monitoring intracranial pressure.

    PubMed

    Carvalho, Lilian Regina de; Évora, Yolanda Dora Martinez; Zem-Mascarenhas, Silvia Helena

    2016-08-29

    to assess the usability of a digital learning technology prototype as a new method for minimally invasive monitoring of intracranial pressure. descriptive study using a quantitative approach on assessing the usability of a prototype based on Nielsen's ten heuristics. Four experts in the area of Human-Computer interaction participated in the study. the evaluation delivered eight violated heuristics and 31 usability problems in the 32 screens of the prototype. the suggestions of the evaluators were critical for developing an intuitive, user-friendly interface and will be included in the final version of the digital learning technology. avaliar a usabilidade de um protótipo educacional digital sobre um novo método para monitoração da pressão intracraniana de forma minimamente invasivo para enfermeiros e médicos. estudo descritivo com abordagem quantitativa sobre a avaliação de usabilidade de um protótipo com base nas dez Heurísticas de Nielsen. Participaram quatro especialistas da área de Interação Humano Computador. a avaliação resultou em oito heurísticas violadas e 31 problemas de usabilidade nas 32 telas do protótipo. as sugestões dos avaliadores foram cruciais para o desenvolvimento de uma interface amigável e intuitiva e serão consideradas na versão final da tecnologia educacional digital. evaluar la usabilidad de un prototipo educacional digital sobre un nuevo método para monitorización de la presión intracraneal, de manera mínimamente invasiva. estudio descriptivo con abordaje cuantitativo sobre la evaluación de usabilidad de un prototipo con base en las diez reglas Heurísticas de Nielsen. Participaron cuatro especialistas del área de Interacción Humana Computador. la evaluación resultó en ocho reglas heurísticas violadas y 31 problemas de usabilidad en las 32 pantallas del prototipo. las sugestiones de los evaluadores fueron cruciales para el desarrollo de una interfaz amigable e intuitiva y éstas serán consideradas en la

  10. Intraoperative near-infrared fluorescent imaging during robotic operations.

    PubMed

    Macedo, Antonio Luiz de Vasconcellos; Schraibman, Vladimir

    2016-01-01

    The intraoperative identification of certain anatomical structures because they are small or visually occult may be challenging. The development of minimally invasive surgery brought additional difficulties to identify these structures due to the lack of complete tactile sensitivity. A number of different forms of intraoperative mapping have been tried. Recently, the near-infrared fluorescence imaging technology with indocyanine green has been added to robotic platforms. In addition, this technology has been tested in several types of operations, and has advantages such as safety, low cost and good results. Disadvantages are linked to contrast distribution in certain clinical scenarios. The intraoperative near-infrared fluorescent imaging is new and promising addition to robotic surgery. Several reports show the utility of this technology in several different procedures. The ideal dose, time and site for dye injection are not well defined. No high quality evidence-based comparative studies and long-term follow-up outcomes have been published so far. Initial results, however, are good and safe. RESUMO A identificação intraoperatória de certas estruturas anatômicas, por seu tamanho ou por elas serem ocultas à visão, pode ser desafiadora. O desenvolvimento da cirurgia minimamente invasiva trouxe dificuldades adicionais, pela falta da sensibilidade tátil completa. Diversas formas de detecção intraoperatória destas estruturas têm sido tentadas. Recentemente, a tecnologia de fluorescência infravermelha com verde de indocianina foi associada às plataformas robóticas. Além disso, essa tecnologia tem sido testada em uma variedade de cirurgias, e suas vantagens parecem estar ligadas a baixo custo, segurança e bons resultados. As desvantagens estão associadas à má distribuição do contraste em determinados cenários. A imagem intraoperatória por fluorescência infravermelha é uma nova e promissora adição à cirurgia robótica. Diversas séries mostram

  11. Aspergilosis cervical con diseminación al sistema nervioso central. Presentación de un caso y revisión de bibliografía

    PubMed Central

    Vergara, Guillermo Enrique; Roura, Natalia; del Castillo, Marcelo; Mora, Andrea; Alcorta, Santiago Condomi; Mormandi, Rubén; Cervio, Andrés; Salvat, Jorge

    2015-01-01

    Introducción: la Aspergilosis Invasiva (AI) del Sistema Nervioso Central (SNC) es infrecuente y ocurre generalmente en pacientes inmunocomprometidos. Puede presentarse con cuadros de meningitis, aneurismas micóticos, infartos o abscesos. Es una infección con pronóstico reservado y puede afectar el SNC de forma primaria o secundaria a partir de un foco que se disemina por vía hematógena. Presentamos el caso de un paciente con AI con invasión primaria a nivel óseo y diseminación posterior al cerebro. Caso clínico: Paciente masculino de 25 años con diagnóstico de leucemia linfática aguda en tratamiento quimioterápico que presentó neumonitis por metotrexate por lo que inicia tratamiento con corticoides. Posteriormente agregó cervicalgia y con el diagnóstico de osteomielitis cervical se realiza punción bajo tomografía computada (TC) sin aislarse gérmenes. Se colocó Halo Vest e inició tratamiento antibiótico empírico. Posteriormente presentó afasia de expresión secundaria a lesión frontal izquierda. Se realizó evacuación de absceso cerebral aislando A. fumigatus. El tratamiento antibiótico específico posterior permitió una buena respuesta clínica y radiológica. Conclusión: La presencia de lesiones en el SNC de pacientes inmunocomprometidos debe incluir a las micosis como diagnóstico diferencial. La evacuación quirúrgica permite llegar rápidamente al diagnóstico mejorando la respuesta posterior al tratamiento antibiótico. Para evaluar la respuesta terapéutica y posibles recaídas se debe realizar un seguimiento periódico clínico radiológico. Palabras clave: Aspergilosis cerebral; Aspergilosis cervical; Aspergilosis invasiva; Voriconazol. PMID:26600985

  12. Trend-surface analysis of morphometric parameters: A case study in southeastern Brazil

    NASA Astrophysics Data System (ADS)

    Grohmann, Carlos Henrique

    2005-10-01

    Trend-surface analysis was carried out on data from morphometric parameters isobase and hydraulic gradient. The study area, located in the eastern border of Quadrilátero Ferrífero, southeastern Brazil, presents four main geomorphological units, one characterized by fluvial dissection, two of mountainous relief, with a scarp of hundreds of meters of fall between them, and a flat plateau in the central portion of the fluvially dissected terrains. Morphometric maps were evaluated in GRASS-GIS and statistics were made on R statistical language, using the spatial package. Analysis of variance (ANOVA) was made to test the significance of each surface and the significance of increasing polynomial degree. The best results were achieved with sixth-order surface for isobase and second-order surface for hydraulic gradient. Shape and orientation of residual maps contours for selected trends were compared with structures inferred from several morphometric maps, and a good correlation is present.

  13. ENDOSCOPIC SLEEVE GASTROPLASTY FOR OBESITY TREATMENT: TWO YEARS OF EXPERIENCE.

    PubMed

    Lopez-Nava, Gontrand; Galvão, M P; Bautista-Castaño, I; Fernandez-Corbelle, J P; Trell, M; Lopez, N

    2017-01-01

    Bariatric endoscopic techniques are minimally invasive and induce gastric volume reduction to treat obesity. Aim : To evaluate endoscopic sleeve gastroplasty (Apollo method) using a suturing method directed at the greater curvature, as well as the perioperative care, two year safety and weight loss. Prospective single-center study over 154 patients (108 females) using the endoscopic sleeve gastroplasty procedure under general anesthesia with overnight inpatient observation. Of the154 initial patients, 143 were available for 1-month of follow-up, 133 for 6-month, 64 for 12-month and 28 completed the 24 month assessment. Follow-up was carried out by a multidisciplinary team (nutritionist and psychologist). Outcomes evaluated were: change in BMI; change in body weight (TBWL); % of loss of initial body weight (%TBWL); % of excess body weight loss (%EWL) (segregated in > or <25% and adverse effects. Voluntary oral contrasted radiological examinations were scheduled to assess the gastroplasty at different times post-procedure. Mean age was 44.9 (23-69) years. At 24 months after the procedure baseline mean BMI change from 38.3 to 30.8 kg/m2. TBWL, %TBWL and %EWL were of 21.3 kg, 19.5% and 60.4% respectively. 85.7% of patients achieve the goal of >25% %EWL. There were no mayor adverse events intraprocedure or during the 24 months of follow-up . Endoscopic sleeve gastroplasty with regular monitoring by a multidisciplinary team can be considered an effective, safe and well tolerated procedure for obesity treatment, at least for two years of follow-up. As técnicas de endoscopia bariátrica são minimamente invasivas e induzem à redução do volume gástrico para tratar a obesidade. Avaliar a gastroplastia sleeve endoscópica (método Apollo) usando um método de sutura direcionado para a grande curvatura, bem como os cuidados perioperatórios, segurança em dois anos e perda de peso. Estudo prospectivo em um único centro com 154 pacientes (108 mulheres) usando o

  14. Applications for a hybrid operating room in thoracic surgery: from multidisciplinary procedures to --image-guided video-assisted thoracoscopic surgery.

    PubMed

    Terra, Ricardo Mingarini; Andrade, Juliano Ribeiro; Mariani, Alessandro Wasum; Garcia, Rodrigo Gobbo; Succi, Jose Ernesto; Soares, Andrey; Zimmer, Paulo Marcelo

    2016-01-01

    The concept of a hybrid operating room represents the union of a high-complexity surgical apparatus with state-of-the-art radiological tools (ultrasound, CT, fluoroscopy, or magnetic resonance imaging), in order to perform highly effective, minimally invasive procedures. Although the use of a hybrid operating room is well established in specialties such as neurosurgery and cardiovascular surgery, it has rarely been explored in thoracic surgery. Our objective was to discuss the possible applications of this technology in thoracic surgery, through the reporting of three cases. RESUMO O conceito de sala híbrida traduz a união de um aparato cirúrgico de alta complexidade com recursos radiológicos de última geração (ultrassom, TC, radioscopia e/ou ressonância magnética), visando a realização de procedimentos minimamente invasivos e altamente eficazes. Apesar de bem estabelecido em outras especialidades, como neurocirurgia e cirurgia cardiovascular, o uso da sala hibrida ainda é pouco explorado na cirurgia torácica. Nosso objetivo foi discutir as aplicações e as possibilidades abertas por essa tecnologia na cirurgia torácica através do relato de três casos.

  15. Validation of maternal cardiac output assessed by transthoracic echocardiography against pulmonary artery catheterization in severely ill pregnant women: prospective comparative study and systematic review.

    PubMed

    Cornette, J; Laker, S; Jeffery, B; Lombaard, H; Alberts, A; Rizopoulos, D; Roos-Hesselink, J W; Pattinson, R C

    2017-01-01

    ámicos serios, debido a los cuales existe la necesidad de sistemas validados de monitorización hemodinámica para mujeres embarazadas. Aunque la cateterización de la arteria pulmonar (CAP) mediante termodilución es el patrón de referencia clínico para la medición del gasto cardíaco (GC), este método se usa con poca frecuencia debido a su naturaleza invasiva. La ecocardiografía transtorácica (ETT) permite la determinación no invasiva del GC. El objetivo de este estudio fue validar la ETT frente al CAP para determinar el GC en mujeres embarazadas gravemente enfermas. MÉTODOS: Este estudio consistió en un metaanálisis que combinó datos de un estudio prospectivo y una revisión sistemática. El estudio prospectivo se llevó a cabo en Pretoria (Sudáfrica) en 2003. Se incluyeron mujeres con complicaciones graves en el embarazo que requerían una monitorización invasiva mediante CAP según las directrices de ese momento. Se realizó una ETT en un plazo de 15 minutos de haber realizado el CAP y el investigador no tuvo acceso a las mediciones del CAP. Las mediciones comparativas se extrajeron de estudios similares obtenidos a partir de una revisión sistemática de la literatura y se añadieron a una base de datos. Se compararon las mediciones simultáneas del GC mediante ETT y CAP. La concordancia entre métodos se evaluó a través del método estadístico de Bland-Altman y de coeficientes de correlación intraclase (CCI). Se incluyeron treinta y cuatro mediciones comparativas en el metaanálisis. Los valores medios del GC obtenidos mediante CAP y ETT fueron de 7,39 l/min y 7.18 l/min, respectivamente. El sesgo fue de 0,21 l/min, siendo los límites inferior y superior de la concordancia de -1,18 l/min y 1.60 l/min; el error porcentual fue del 19,1%, y el CCI entre ambos métodos fue de 0,94. Las mediciones del GC en mujeres embarazadas mediante ETT muestran una excelente concordancia con las obtenidas mediante CAP. Dada su naturaleza no invasiva y su

  16. Cosmogenic 3He in hematite and goethite from Brazilian "canga" duricrust demonstrates the extreme stability of these surfaces

    NASA Astrophysics Data System (ADS)

    Shuster, David L.; Farley, Kenneth A.; Vasconcelos, Paulo M.; Balco, Greg; Monteiro, Hevelyn S.; Waltenberg, Kathryn; Stone, John O.

    2012-05-01

    Helium isotopes were measured in hematite and goethite samples from several lateritiric duricrusts (canga) developed on banded iron formations. These samples uniformly have high 3He concentrations which must arise from long periods of cosmic ray exposure. From coexisting phases from the Quadrilátero Ferrífero in east central Brazil, we determined the ratio of cosmogenic 3He in hematite to that of 21Ne in quartz to be 3.96 ± 0.19. Combined with best current estimates of the 21Ne production rate in quartz, this ratio implies a sea-level high latitude (SLHL) 3He production rate in hematite of 68.1 ± 8.1 atoms/g/yr; from the chemical composition we estimate the 3He production rate in goethite to be ~ 5% higher. We use these production rate estimates to interpret 3He concentrations measured in goethite and hematite from a ~ 10 m depth profile collected from a surface canga in Carajás, in the Amazon basin of Brazil. We find that the Carajás canga has experienced a very low rate of surface erosion (~ 0.16-0.54 m/Myr) over at least the last few millions of years. This iron-rich canga surface is remarkably resistant to erosion despite its location in a wet tropical environment. Details of the depth profile suggest that despite its stability, the canga has also been internally dynamic (translocation of material; solution and reprecipitation) over million-year timescales.

  17. Aspects of the ecology of phlebotomine sand flies (Diptera: Psychodidae) in the Private Natural Heritage Reserve Sanctuary Caraça.

    PubMed

    Tonelli, Gabriel Barbosa; Tanure, Aline; Rêgo, Felipe Dutra; Carvalho, Gustavo Mayr de Lima; Simões, Taynãna César; Andrade Filho, José Dilermando

    2017-01-01

    Leishmaniases are a set of parasitic diseases of zoonotic origin that are transmitted by sandfly vectors in wild, rural and urban environments. Their distribution is dependent not only the distribution of vectors, but also on the distribution of mammalian reservoirs. Only by understanding the transmission cycle of these diseases, such as knowing the participating vectors and reservoirs, can one can understand the epidemiology and ecological relationships of leishmaniases. Ecotourism has become an important area of economic growth in Brazil. One of the most visited tourist attractions in the state of Minas Gerais, the Reserva Particular do Patrimônio Natural Santuário do Caraça (RPPNSC) is located in the Quadrilátero Ferrífero. The aim of this study was to contribute to the control of leishmaniasis among tourists of the RPPNPC by surveying its sand fly fauna and testing for the presence of Leishmania DNA in females. Twenty-five CDC light traps were exposed on 7 trails of the RPPNPC where samples were collected bimonthly for a year, starting in June 2013. A total of 376 specimens of 18 species and 10 genera of sandflies were captured. The predominant species were Psychodopygus lloydi (72.34%) and Pintomyia monticola (5.59%). HaeIII restriction enzyme detected and characterized Leishmania braziliensis DNA in 2 of the samples for an infection rate of 0.7% (2/266). Recent studies found specimens of Ps. lloyd infected with Leishmania braziliensis elsewhere in Minas Gerais, which may be an indication that this species is involved in the transmission of Leishmania in this state.

  18. (U-Th)/He geochronology of goethite and the origin and evolution of cangas

    NASA Astrophysics Data System (ADS)

    Monteiro, Hevelyn S.; Vasconcelos, Paulo M.; Farley, Kenneth A.; Spier, Carlos A.; Mello, Claudio L.

    2014-04-01

    (U-Th)/He geochronology of 147 grains of goethite cements extracted from ferruginous duricrusts (cangas) developed on banded iron-formations from the Quadrilátero Ferrífero region, Minas Gerais, Brazil, records a history of protracted mineral dissolution-reprecipitation that started at ca. 48.1 ± 4.8 Ma and continues intermittently until the Present. A large majority of the samples (more than 30%) are younger than 2 Ma, revealing active mineral dissolution-reprecipitation in the recent past. Within cangas, goethite cements are younger near the surface and become progressively older towards the bottom of the weathering profile, indicating that iron is more effectively cycled in the parts of the weathering profile more strongly affected by biogenic activity. (U-Th)/He geochronology of 14 goethite grains from saprolites in the same profiles yield results ranging from 55.3 ± 5.5 to 25.7 ± 2.6 Ma. For a single weathering profile, goethite cements from cangas are invariably younger than goethite grains from the underlying saprolite, indicating that the duricrust and the saprolite behave as independent and separate systems responding to different environmental controls. Thorium shows conservative behaviour during goethite dissolution-reprecipitation, and it is enriched towards the surface of the weathering profile. Uranium, on the other hand, is preferentially leached from the surface into the saprolite or out of the weathering profile. Recurrent goethite dissolution-reprecipitation lends great textural complexities to cangas, but it is also responsible for its capacity to reheal when physically disrupted. This self-healing property accounts for canga’s role in armoring banded iron-formation landscapes.

  19. Robotic-assisted modified retroauricular cervical approach: initial experience in Latin America.

    PubMed

    Chulam, Thiago Celestino; Lira, Renan Bezerra; Kowalski, Luiz Paulo

    2016-01-01

    to evaluate the thickness of the gastric wall at the time of intra gastric balloon (IGB) placement, at the time of its withdrawal and one month after withdrawal. fifteen morbidly obese patients underwent the introduction of IGB under general anesthesia. In all patients, there was infusion of 500ml of distilled water in the balloon for the test. Measurements of the thickness of the gastric wall were made in the antrum, body and proximal body, using a radial echoendoscope with a frequency of 12MHz and maximum zoom, and its own balloon inflated with 5ml of distilled water. the presence of IGB led to increased wall thickness of the gastric body by expanding the muscle layer. These changes were apparently transient, since 30 days after the balloon withdrawal there was a tendency to return of the wall thickness values ​​observed before the balloon insertion. the use of intragastric balloon for the treatment of obesity determines transient increase in the wall thickness of the gastric body caused by expanded muscle layer. A preocupação com a melhoria dos resultados estéticos e funcionais sem comprometimento dos resultados oncológicos na cirurgia de cabeça e pescoço tem aumentado significativamente. Os procedimentos minimamente invasivos e principalmente aqueles que utilizam a tecnologia robótica permitiram o desenvolvimento de novas abordagens, incluindo o acesso retroauricular, que agora é usado rotineiramente, especialmente na Coréia do Sul. A presente nota irá ilustrar a técnica e a experiência inicial na América Latina, demonstrando que esta abordagem é viável, segura e eficaz oncologicamente, podendo ser utilizada em casos selecionados com um benefício estético evidente.

  20. Non-Invasive Ventilation in Patients with Heart Failure: A Systematic Review and Meta-Analysis.

    PubMed

    Bittencourt, Hugo Souza; Reis, Helena França Correia Dos; Lima, Melissa Santos; Gomes, Mansueto

    2017-02-01

    Non-invasive ventilation (NIV) may perfect respiratory and cardiac performance in patients with heart failure (HF). The objective of the study to establish, through systematic review and meta-analysis, NIV influence on functional capacity of HF patients. A systematic review with meta-analysis of randomized studies was carried out through research of databases of Cochrane Library, SciELO, Pubmed and PEDro, using the key-words: heart failure, non-invasive ventilation, exercise tolerance; and the free terms: bi-level positive airway pressure (BIPAP), continuous positive airway pressure (CPAP), and functional capacity (terms were searched for in English and Portuguese) using the Boolean operators AND and OR. Methodological quality was ensured through PEDro scale. Weighted averages and a 95% confidence interval (CI) were calculated. The meta-analysis was done thorugh the software Review Manager, version 5.3 (Cochrane Collaboration). Four randomized clinical trials were included. Individual studies suggest NIV improved functional capacity. NIV resulted in improvement in the distance of the six-minute walk test (6MWT) (68.7m 95%CI: 52.6 to 84.9) in comparison to the control group. We conclude that the NIV is an intervention that promotes important effects in the improvement of functional capacity of HF patients. However, there is a gap in literature on which are the most adequate parameters for the application of this technique. Resumo A ventilação não invasiva (VNI) pode aperfeiçoar o desempenho cardíaco e respiratório dos pacientes com insuficiência cardíaca (IC). O objetivo do estudo é estabelecer, por meio de revisão sistemática e meta-análise, a influência da VNI na capacidade funcional (CF) de indivíduos com IC. Foi realizada uma revisão sistemática com meta-análise de estudos randomizados através da pesquisa nas bases de dados Biblioteca Cochrane, SciELO, Pubmed e PEDro, utilizando-se as palavras-chave: insuficiência cardíaca, ventilação n

  1. Stages of change of behavior in women on a multi-professional program for treatment of obesity.

    PubMed

    Bevilaqua, Cheila Aparecida; Pelloso, Sandra Marisa; Marcon, Sonia Silva

    2016-10-10

    pré dispostas a realizarem mudanças na alimentação e na atividade física. No entanto, só foi observada diferença significativa em relação ao peso, índice de massa corporal (IMC), circunferência da cintura e relação cintura-quadril e prontidão para mudança entre as integrantes do grupo intervenção. a intervenção programada foi efetiva na perda de peso, diminuição da circunferência da cintura e relação cintura-quadril e na mudança de comportamentos relacionados à prática de exercícios físicos e alimentar. verificar la efectividad de un programa de intervención sobre medidas antropométricas y de la fase de preparación para cambio de comportamiento, en mujeres con exceso de peso. el grupo intervención (GI) estuvo constituido por 13 mujeres y el grupo control por 20. La intervención tuvo duración de 16 semanas e incluyó práctica orientada de actividad física tres veces en la semana y educación en salud una vez por semana. La aplicación del cuestionario de fase de preparación para cambio de comportamiento y para las evaluaciones antropométricas fueron realizadas en dos momentos, antes y después del período de intervención. El análisis estadístico se realizó con pruebas de comparación y asociación. en general, en el momento inicial, las participantes de los dos grupos estaban predispuestas a realizar cambios en la alimentación y en la actividad física. Sin embargo, solamente entre las integrantes del grupo intervención fue observada diferencia significativa en relación: al peso; al índice de masa corporal (IMC); a la circunferencia de la cintura y relación cintura-cadera; y, a la preparación para el cambio. la intervención programada fue efectiva en: pérdida de peso, disminución de la circunferencia de la cintura y relación cintura-cadera, y en el cambio de comportamiento relacionado a la práctica de ejercicios físicos y de alimentación.

  2. The effects of acupressure on labor pains during child birth: randomized clinical trial.

    PubMed

    Mafetoni, Reginaldo Roque; Shimo, Antonieta Keiko Kakuda

    2016-08-08

    ções, por 20 minutos, e a intensidade da dor avaliada por meio de uma Escala Analógica Visual (EAV). as médias de dor pela EAV não foram diferentes nos três grupos na admissão (p-valor=0,0929), porém foram menores no grupo de acupressão imediatamente após (p-valor=<0,0001) e com 1 h do tratamento (p-valor=0,0001) ao se comparar com placebo e controle. a acupressão no ponto sanyinjiao se mostrou uma medida útil no alívio da dor, não invasiva e um meio de melhorar a qualidade dos cuidados a parturiente. Registro: RBR-9mhs8r. analizar los efectos de la acupresión, en el punto sanyinjiao, sobre el dolor en la fase activa del trabajo de parto, en embarazadas atendidas en maternidad pública. ensayo clínico controlado y aleatorio, simple ciego y de carácter pragmático. Fueron seleccionadas 156 mujeres con edad gestacional ≥ 37 semanas, dilatación cervical ≥ 4 cm y con dos o más contracciones en 10 minutos. Las embarazadas fueron divididas aleatoriamente en tres grupos en un hospital universitario del interior del estado de Sao Paulo, Brasil, para recibir acupresión, placebo o participar como control. La acupresión fue aplicada en el punto sanyinjiao durante las contracciones, por 20 minutos; la intensidad del dolor fue evaluada por medio de una Escala Analógica Visual (EAV). los promedios del dolor por la EAV no fueron diferentes en los tres grupos en la admisión (valor p=0,0929), sin embargo fueron menores en el grupo de acupresión inmediatamente después (valor p=<0,0001) y también después de 1 hora del tratamiento (valor p=0,0001) al compararse con el placebo y control. la acupresión en el punto sanyinjiao se mostró una medida útil en el alivio del dolor, no invasiva y un medio de mejorar la calidad de los cuidados la parturienta. Registro: RBR-9mhs8r.

  3. Curva de aprendizaje en la colocación de tornillos pediculares percutáneos mínimamente invasivos

    PubMed Central

    Landriel, Federico; Hem, Santiago; Rasmussen, Jorge; Vecchi, Eduardo; Yampolsky, Claudio

    2018-01-01

    Resumen Objetivo: El objetivo de este estudio fue estimar la curva de aprendizaje necesaria para la correcta colocación de tornillos transpediculares percutáneos (TTP). Introducción: Los TTP son la forma de instrumentación más utilizada en el tratamiento quirúrgico de lesiones espinales que requieren estabilización. Métodos: Evaluamos retrospectivamente la inserción de 422 TTP (T5 a S1) en 75 pacientes operados entre 2013–2016, bajo guía fluoroscópica bidimensional. El cirujano 1 colocó siempre los tornillos del lado derecho y el cirujano 2, la totalidad del lado izquierdo. El posicionamiento y ruptura pedicular fue determinando con la clasificación tomográfica de Gertzbein. Se comparó la precisión en la colocación de TTP de nuestra serie con una tasa de ruptura de 8,08% (rango de 0,67-20,83%), valor de referencia obtenido de un meta-análisis propio. Resultados: De los 422 TTP, 395 fueron insertados en el pedículo sin violación de su cortical (Grado 1 = 93,6%), 27 (6,4%) rompieron la pared pedicular, de los cuales el 3,8% fue Grado 2, el 1,65% Grado 3 y sólo el 0,9% Grado 4. El Cirujano 1, presentó una tasa se ruptura global de 6,6%, alcanzando valores estándares de precisión al colocar 74 TTP; el Cirujano 2 presentó una tasa de ruptura de 6,1%, alcanzando valores de referencia a los 64 TTP; la diferencia entre ambos no fue estadísticamente significativa (P = 0,9009). Conclusión: En la serie evaluada se evidenció que se necesitan colocar aproximadamente 70 TTP para lograr resultados en términos de exactitud intrapedicular comparables con lo reportado por cirujanos experimentados en esta técnica mínimamente invasiva. PMID:29900033

  4. Key parameters for low-grade fine-grained iron ore valorization: lower environmental impact through reduced waste.

    NASA Astrophysics Data System (ADS)

    Wagner, Christiane; Orberger, Beate; Tudryn, Alina; Baptiste, Benoît; Wirth, Richard; Morgan, Rachel; Miska, Serge

    2016-04-01

    In low-grade banded iron formations (BIFs), a large part of the iron is related to micro- and nano- metric iron-bearing inclusions within quartz and/or carbonates, mainly dolomite (~ 20 to 50 μm). Low-grade fine grained iron ore present two types of environmental risks: a) they are often stocked as tailings. For example, the recent disaster (5th of November 2015) in the Minas Gerais district, Brazil, was caused by the collapse of the Fundão tailings dam at an open cast mine; b) during beneficiation significant amounts of dust are generated also leading to metal loss. A laminated BIF studied from a drill core at Àguas Claras Mine, Quadrilátero Ferrífero, Brazil, contains 26.71 wt. % total iron, 0.2 wt. % SiO2, 0.32 wt.% MnO, 15.46 wt. % MgO, 22.32 wt.% CaO, 0.09 wt. % P2O5, < 0.05 wt. % Al2O3, 0.15 wt. % H2O and 34.08 wt. % CO2. Environmental hazardous elements are present as traces (As: 3-20 ppm, Cd: 0-0.7 ppm; Cr: 0.05-60 ppm, Pb: up to 55 ppm; U: up to 8 ppm). Dolomite and quartz bands alternate with hematite bands. Raman spectroscopy, X-ray diffraction and FIB-TEM analyses reveal that the micro- and nano- metric inclusions in dolomite are hematite and minor goethite, partly occurring as clusters in voids. Curie Balance analyses were carried out at different heating steps and temperatures on whole rock samples and a synthetic mix of decarbonated sample and pure dolomite. X-ray diffraction on the products of the heating experiments shows that that hematite is stable and new phases: magnesioferrite (MgFe2O4), lime (CaO), periclase (MgO), portlandite (Ca(OH)2) and srebrodoskite (Ca2Fe2O5) were formed between 680 °C and 920 °C. These findings promote the economic use of low grade ores rather than their stockpiling as tailings. The presence of OH-bearing goethite reduces the sintering temperature. After having separated coarse hematite from barren dolomite and quartz, a low temperature sintering of the inclusion-bearing dolomite/quartz leads to transformations

  5. Mouthpiece ventilation in Duchenne muscular dystrophy: a rescue strategy for noncompliant patients.

    PubMed

    Fiorentino, Giuseppe; Annunziata, Anna; Cauteruccio, Rosa; Frega, Gianfranco Scotto di; Esquinas, Antonio

    2016-01-01

    To evaluate mouthpiece ventilation (MPV) in patients with Duchenne muscular dystrophy (DMD) who are noncompliant with noninvasive ventilation (NIV). We evaluated four young patients with DMD who had previously refused to undergo NIV. Each patient was reassessed and encouraged to try MPV. The four patients tolerated MPV well and were compliant with NIV at home. MPV proved to be preferable and more comfortable than NIV with any other type of interface. Two of the patients required overnight NIV and eventually agreed to use a nasal mask during the night. The advantages of MPV over other types of NIV include fewer speech problems, better appearance, and less impact on the patient, eliminating the risk of skin breakdown, gastric distension, conjunctivitis, and claustrophobia. The use of a mouthpiece interface should be always considered in patients with DMD who need to start NIV, in order to promote a positive approach and a rapid acceptance of NIV. Using MPV during the daytime makes patients feel safe and more likely to use NIV at night. In addition, MPV increases treatment compliance for those who refuse to use other types of interfaces. Avaliar a ventilação bucal (VB) em pacientes com distrofia muscular de Duchenne (DMD) não aderentes à ventilação não invasiva (VNI). Foram avaliados quatro pacientes jovens com DMD que anteriormente recusaram-se a se submeter à VNI. Cada paciente foi reavaliado e encorajado a tentar VB. Os quatro pacientes toleraram bem a VB e aderiram ao uso de VNI em casa. O uso de VB provou ser uma alternativa preferível e mais confortável que o uso de VNI com qualquer outro tipo de interface. Dois dos pacientes necessitaram de VNI noturna e eventualmente aceitaram utilizar uma máscara nasal durante a noite. As vantagens da VB sobre outros tipos de VNI incluem menores problemas na fala, melhor aparência e menor impacto no paciente, eliminando o risco de lesões na pele, distensão gástrica, conjuntivite e claustrofobia. O uso da

  6. Identifying knickpoints using elevation breaks and offsets in slope-area scaling

    NASA Astrophysics Data System (ADS)

    Peifer Bezerra, Daniel; Persano, Cristina

    2017-04-01

    passive margin river system, the Quadrilátero Ferrífero - Brazil, that exhibits (i) high relief (max. relief is 1400 m, max. elevation is 2080 m); (ii) presence of knickpoints; (iii) an absence of Quaternary glaciation. Therefore, we seek to test the different methods of identification of knickpoints in a mountainous landscape where we had field constraints of knickpoints. There are two main criteria for the identification of knickpoints: (1) elevation/gradient breaks or; (2) offsets in trends of slope-area scaling. Both of those criteria are somehow subjective as the values for the breaks in (1) as well as the regression limits for the slope-area scaling (2) are arbitrary. We show that the use of those different criteria prescribes different results; the knickpoints identified for both methods are not interchangeable. The method (1) define a higher number of knickpoints than (2) that are more easily identified in the field than the knickpoints that stem from (2). Many times the knickpoints identified from (1) are subsequent, meaning that they are a knickzone rather than a knickpoint. The method (2) is more robust for the characterization of knickzones than (1). We suggest a combined approach for the identification of knickpoints as well as arbitrary values for defining it.

  7. Relationship Between Neck Circumference and Epicardial Fat Thickness in a Healthy Male Population.

    PubMed

    Küçük, Uğur; Küçük, Hilal Olgun; Cüce, Ferhat; Balta, Sevket

    2016-09-01

    subcutânea são limitados. Realizamos um estudo para determinar a associação entre a circunferência do pescoço e a espessura da gordura epicárdica em jovens saudáveis do sexo masculino, além de avaliar as suas correlações individuais com a adiposidade corporal geral e fatores de risco cardiometabólicos. Cem pacientes consecutivos do sexo masculino com idade igual ou superior a 18 anos e sem nenhuma condição médica importante e conhecida foram incluídos no estudo. Todos os participantes foram submetidos a um exame físico detalhado que incluiu medida da pressão arterial, peso, altura, razão cintura/quadril e circunferência do pescoço. Sangue foi coletado para determinação da glicemia de jejum e parâmetros lipídicos. Um exame ecocardiográfico padrão foi realizado com determinação adicional da espessura da gordura epicárdica. Entre os 100 participantes do estudo, a circunferência do pescoço mostrou correlação significativa com o peso, circunferência de cintura, IMC, glicemia e níveis séricos de colesterol total, lipoproteína de baixa densidade (LDL-colesterol) e triglicerídeos. Não foi observada correlação significativa entre a circunferência do pescoço e níveis de colesterol de alta densidade (HDL-colesterol). A circunferência do pescoço correlacionou moderadamente e positivamente com a espessura da gordura epicárdica à ecocardiografia. Entre pacientes com baixo risco cardiometabólico, o aumento da circunferência do pescoço foi associado a um aumento da espessura da gordura epicárdica.

  8. Increased ultrasensitive C-reactive protein is not associated with obesity in hospitalized heart failure patients.

    PubMed

    Schommer, Vânia Ames; Stein, Airton Tetelbom; Marcadenti, Aline; Wittke, Estefania Inez; Galvão, André Luís Câmara; Rosito, Guido Bernardo Aranha

    2016-01-01

    To evaluate the association between obesity and levels of high-sensitivity C-reactive protein (hs-CRP) in patients with heart failure admitted to a tertiary hospital. Cross-sectional study with a consecutive sampling of hospitalized patients with heart failure. Sociodemographic and clinical data were collected, and the nutritional status was assessed through indicators such as body mass index (in kg/m2), waist circumference (in cm), waist-hip ratio, triceps skinfold (in mm) and subscapularis skinfold (in mm). Neck circumference (in cm) was measured as well as serum levels of hs-CRP, in mg/L. Among 123 patients, the mean age was 61.9±12.3 years and 60.2% were male. The median of hs-CRP was 8.87mg/L (3.34 to 20.01). A tendency to an inverse correlation between neck circumference and hs-CRP was detected (r=-0.167; p=0.069). In the multiple linear regression analysis, after adjustment for age, disease severity (NYHA classification III and IV, low ejection fraction, left ventricular dysfunction during diastole), and infectious conditions there was an inverse association between hs-CRP and neck circumference (ß=-0.196; p=0.03) and subscapularis skinfold (ß=-0.005; p=0.01) in the total sample, which was not maintained after the stratification by sex. Increased levels of hs-CRP in patients hospitalized for heart failure were not associated with obesity. Avaliar a associação entre obesidade e níveis de proteína c-reativa ultrassensível (PCR-us) em pacientes com insuficiência cardiac admitidos em um hospital terciário. Estudo transversal com amostragem consecutiva de pacientes com insuficiência cardíaca hospitalizados. Foram coletados dados sociodemográficos e clínicos, e o estado nutricional foi avaliado por meio de indicadores como índice de massa corporal (em kg/m2), circunferência da cintura (em cm), razão cintura-quadril, dobra cutânea tricipital (em mm) e dobra cutânea subescapular (em mm). Circunferência do pescoço (em cm) foi aferida bem como n

  9. High-grade iron ore at Windarling, Yilgarn Craton: a product of syn-orogenic deformation, hypogene hydrothermal alteration and supergene modification in an Archean BIF-basalt lithostratigraphy

    NASA Astrophysics Data System (ADS)

    Angerer, Thomas; Hagemann, Steffen G.; Danyushevsky, Leonid

    2013-08-01

    , carbonate and quartz to form veins and breccia but did not generate significant volumes of iron ore. Ore stage 4 involved Mesozoic(?) to recent supergene oxidation and hydration in a weathering environment reaching down to depths of ˜100 to maximum 200 m below surface. Supergene ore formation involved goethite replacement of dolomite and quartz as well as martitisation. Important `ground preparation' for supergene modification and upgrade were mainly the formation of steep D1 to D4 structures, steep BIF/basalt margins and particularly the syn-D1 to syn-D2 carbonate alteration of BIF that is most susceptible to supergene dissolution. The Windarling deposits are structurally controlled, supergene-modified hydrothermal iron ore systems that share comparable physical, chemical and ore-forming characteristics to other iron ore deposits in the Yilgarn Craton (e.g. Koolyanobbing, Beebyn in the Weld Range, Mt. Gibson). However, the remarkable variety in pre-, syn- and post-deformational ore textures (relative to D1 and D2) has not been described elsewhere in the Yilgarn and are similar to the ore deposits in high-strain zones, such as of Brazil (Quadrilátero Ferrífero or Iron Quadrangle) and Nigeria. The overall similarity of alteration stages, i.e. the sequence of hydrothermal carbonate introduction and hypogene leaching, with other greenstone belt-hosted iron ore deposits supports the interpretation that syn-orogenic BIF alteration and upgrade was crucial in the formation of hypogene-supergene iron ore deposits in the Yilgarn Craton and possibly in other Archean/Paleoproterozoic greenstone belt settings worldwide.

  10. Influence of the ventilatory mode on acute adverse effects and facial thermography after noninvasive ventilation.

    PubMed

    Pontes, Suzy Maria Montenegro; Melo, Luiz Henrique de Paula; Maia, Nathalia Parente de Sousa; Nogueira, Andrea da Nóbrega Cirino; Vasconcelos, Thiago Brasileiro; Pereira, Eanes Delgado Barros; Bastos, Vasco Pinheiro Diógenes; Holanda, Marcelo Alcantara

    2017-01-01

    To compare the incidence and intensity of acute adverse effects and the variation in the temperature of facial skin by thermography after the use of noninvasive ventilation (NIV). We included 20 healthy volunteers receiving NIV via oronasal mask for 1 h. The volunteers were randomly divided into two groups according to the ventilatory mode: bilevel positive airway pressure (BiPAP) or continuous positive airway pressure (CPAP). Facial thermography was performed in order to determine the temperature of the face where it was in contact with the mask and of the nasal dorsum at various time points. After removal of the mask, the volunteers completed a questionnaire about adverse effects of NIV. The incidence and intensity of acute adverse effects were higher in the individuals receiving BiPAP than in those receiving CPAP (16.1% vs. 5.6%). Thermographic analysis showed a significant cooling of the facial skin in the two regions of interest immediately after removal of the mask. The more intense acute adverse effects occurred predominantly among the participants in whom the decrease in the mean temperature of the nasal dorsum was lower (14.4% vs. 7.2%). The thermographic visual analysis of the zones of cooling and heating on the face identified areas of hypoperfusion or reactive hyperemia. The use of BiPAP mode was associated with a higher incidence and intensity of NIV-related acute adverse effects. There was an association between acute adverse effects and less cooling of the nasal dorsum immediately after removal of the mask. Cutaneous thermography can be an additional tool to detect adverse effects that the use of NIV has on facial skin. Comparar a incidência e a intensidade de efeitos adversos agudos e a variação da temperatura da pele da face através da termografia após a aplicação de ventilação não invasiva (VNI). Foram incluídos 20 voluntários sadios, de ambos os gêneros, submetidos à VNI com máscara oronasal por 1 h e divididos aleatoriamente em

  11. Zero Calcium Score as a Filter for Further Testing in Patients Admitted to the Coronary Care Unit with Chest Pain.

    PubMed

    Correia, Luis Cláudio Lemos; Esteves, Fábio P; Carvalhal, Manuela; Souza, Thiago Menezes Barbosa de; Sá, Nicole de; Correia, Vitor Calixto de Almeida; Alexandre, Felipe Kalil Beirão; Lopes, Fernanda; Ferreira, Felipe; Noya-Rabelo, Márcia

    2017-06-12

    ), na qual a probabilidade pré-teste de DAC é maior do que em outras populações. Pacientes foram submetidos a tomografia computadorizada para quantificar o escore de cálcio, DAC obstrutiva foi definida por uma estenose mínima de 70% na cineangiocoronariografia invasiva. Um escore clínico para estimar a probabilidade pré-teste de DAC obstrutiva foi criado em amostra de 370 pacientes, usado para definir subgrupos na definição de valores preditivos negativos do escore zero. Em 146 pacientes estudados, a prevalência de DAC foi 41% e o escore de cálcio zero foi demonstrado em 35% deles. A sensibilidade e a especificidade para escore de cálcio zero resultaram numa razão de verossimilhança negativa de 0,16. Após ajuste com um escore clínico com a regressão logística para a probabilidade pré-teste, o escore de cálcio zero foi preditor independente associado a baixa probabilidade de DAC (OR = 0,12, IC95% = 0,04-0,36), aumentando a área abaixo da curva ROC do modelo clínico de 0,76 para 0,82 (p = 0,006). Considerando a probabilidade de DAC < 10% como ponto de corte para alta precoce, o escore de cálcio aumentou a proporção de pacientes para alta precoce de 8,2% para 25% (NRI = 0,20; p = 0,0018). O escore de cálcio zero apresentou valor preditivo negativo de 90%. Em pacientes com probabilidade pré-teste < 50%, o valor preditivo negativo foi 95% (IC95% = 83%-99%). O escore de cálcio zero reduz substancialmente a probabilidade pré-teste de DAC obstrutiva em pacientes internados em UCI com dor torácica aguda. (Arq Bras Cardiol. 2017; [online].ahead print, PP.0-0).

  12. Preclinical atherosclerosis at the time of pre-eclamptic pregnancy and up to 10 years postpartum: systematic review and meta-analysis.

    PubMed

    Milic, N M; Milin-Lazovic, J; Weissgerber, T L; Trajkovic, G; White, W M; Garovic, V D

    2017-01-01

    Ltd. La preeclampsia (PE) es un trastorno hipertensivo específico del embarazo que ha sido asociada con factores de riesgo cardiovascular y cambios vasculares, tales como aterosis aguda en los vasos sanguíneos de la placenta, similares a las primeras etapas de la aterosclerosis. El objetivo de este estudio fue determinar si las mujeres con PE han aumentado la carga aterosclerótica, según lo determinado por el espesor del complejo íntima-media de la arteria carótida (CIMT, por sus siglas en inglés), en comparación con las mujeres sin PE. MÉTODOS: Se realizó una revisión sistemática y un metaanálisis de estudios que reportaron el CIMT, una medida no invasiva de la aterosclerosis subclínica obtenida mediante ecografía, comparando mujeres con PE y mujeres sin ella. Solo se incluyeron estudios llevados a cabo durante el embarazo o durante la primera década después del parto, y en los que se midió el CIMT en la arteria carótida común. Se usaron las bases de datos de PubMed, EMBASE y Web of Science para identificar estudios publicados antes del 7 marzo de 2016. Dos revisores utilizaron formularios y protocolos preestablecidos para evaluar de forma independiente la elegibilidad de los estudios, a partir de los títulos y los resúmenes, y para realizar un cribado del texto completo, un resumen de los datos y una evaluación de calidad. La heterogeneidad se evaluó mediante el test estadístico I 2 . Se usó la diferencia de medias estandarizada (SMD, por sus siglas en inglés) como una medida de la magnitud del efecto. En el metaanálisis se incluyeron catorce estudios. Siete de los estudios se llevaron a cabo durante embarazos complicados por PE, 10 se realizaron hasta 10 años después del parto y tres incluyeron mediciones tomadas en ambos períodos. Las mujeres con PE tuvieron un CIMT significativamente mayor que aquellas que no la tenían, tanto en el momento del diagnóstico (SMD 1,10 (I 95%, 0,73-1,48), P <0,001) como en la primera década despu